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  5. UPSTATE EMERGENCY MEDICINE, INC.

UPSTATE EMERGENCY MEDICINE, INC.

Company Details

Name: UPSTATE EMERGENCY MEDICINE, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 11 Jun 1996 (29 years ago)
Entity Number: 2038127
ZIP code: 13210
County: Onondaga
Place of Formation: New York
Address: 750 E. ADAMS STREET, SYRACUSE, NY, United States, 13210

Contact Details

Phone +1 315-492-5535

Phone +1 315-464-4363

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
HAEKW1AKZ5P8 2025-01-10 750 E ADAMS ST, SYRACUSE, NY, 13210, 2342, USA 750 E ADAMS ST, SYRACUSE, NY, 13210, 2306, USA

Business Information
Doing Business As UPSTATE EMERGENCY MEDICINE INC
Congressional District 22
State/Country of Incorporation NY, USA
Activation Date 2024-01-15
Initial Registration Date 2007-10-29
Entity Start Date 1996-08-01
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 621111
Product and Service Codes R499

Points of Contacts
Electronic Business
Title PRIMARY POC
Name CARLENE DEWANE
Role BUSINESS MANAGER
Address 750 EAST ADAMS STREET, SYRACUSE, NY, 13210, 2306, USA
Title ALTERNATE POC
Name ANGELA SCALISE
Address 750 EAST ADAMS STREET, SYRACUSE, NY, 13210, 2306, USA
Government Business
Title PRIMARY POC
Name CARLENE DEWANE
Role BUSINESS MANAGER
Address 750 EAST ADAMS STREET, SYRACUSE, NY, 13210, 2306, USA
Title ALTERNATE POC
Name ANGELA SCALISE
Address 750 EAST ADAMS STREET, SYRACUSE, NY, 13210, 2306, USA
Past Performance
Title PRIMARY POC
Name CARLENE DEWANE
Role BUSINESS MANAGER
Address 750, SYRACUSE, NY, 13210, USA
Title ALTERNATE POC
Name ANGELA SCALISE
Address 750 EAST ADAMS STREET, SYRACUSE, NY, 13210, USA

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
4WUV2 Active Non-Manufacturer 2007-10-30 2024-03-10 2029-01-15 2025-01-10

Contact Information
POC CARLENE DEWANE
Phone +1 315-464-4864
Fax +1 315-464-6226
Address 750 E ADAMS ST, SYRACUSE, NY, 13210 2342, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner
Vendor Certified 2024-01-15
CAGE number 1QJG2
Company Name STATE UNIVERSITY OF NEW YORK HEALTH SCIENCE CENTER AT SYRACUSE
CAGE Last Updated 2024-05-23
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
UPSTATE EMERGENCY MEDICINE, INC. PROFIT SHARING PLAN 2023 161502502 2024-07-30 UPSTATE EMERGENCY MEDICINE, INC. 69
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2022-01-01
Business code 621111
Sponsor’s telephone number 3154644363
Plan sponsor’s address 750 EAST ADAMS STREET, SYRACUSE, NY, 13210

Signature of
Role Plan administrator
Date 2024-07-30
Name of individual signing WILLIAM PAOLO
UPSTATE EMERGENCY MEDICINE, INC. PROFIT SHARING PLAN 2022 161502502 2023-08-23 UPSTATE EMERGENCY MEDICINE, INC. 67
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2022-01-01
Business code 621111
Sponsor’s telephone number 3154644363
Plan sponsor’s address 750 EAST ADAMS STREET, SYRACUSE, NY, 13210

Signature of
Role Plan administrator
Date 2023-08-23
Name of individual signing WILLIAM PAOLO
UPSTATE EMERGENCY MEDICINE, INC. PROFIT SHARING PLAN 2022 161502502 2023-08-23 UPSTATE EMERGENCY MEDICINE, INC. 90
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 3154644363
Plan sponsor’s address 750 EAST ADAMS STREET, SYRACUSE, NY, 13210

Signature of
Role Plan administrator
Date 2023-08-23
Name of individual signing WILLIAM PAOLO
UPSTATE EMERGENCY MEDICINE, INC. PROFIT SHARING PLAN 2021 161502502 2022-08-31 UPSTATE EMERGENCY MEDICINE, INC. 84
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 3154644363
Plan sponsor’s address 750 EAST ADAMS STREET, SYRACUSE, NY, 13210

Signature of
Role Plan administrator
Date 2022-08-31
Name of individual signing WILLIAM PAOLO
UPSTATE EMERGENCY MEDICINE, INC. PROFIT SHARING PLAN 2020 161502502 2021-10-13 UPSTATE EMERGENCY MEDICINE, INC. 93
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 3154644363
Plan sponsor’s address 750 EAST ADAMS STREET, SYRACUSE, NY, 13210

Signature of
Role Plan administrator
Date 2021-10-13
Name of individual signing WILLIAM PAOLO
UPSTATE EMERGENCY MEDICINE, INC. PROFIT SHARING PLAN 2019 161502502 2020-07-28 UPSTATE EMERGENCY MEDICINE, INC. 89
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 3154644363
Plan sponsor’s address 750 EAST ADAMS STREET, SYRACUSE, NY, 13210

Signature of
Role Plan administrator
Date 2020-07-28
Name of individual signing WILLIAM PAOLO
UPSTATE EMERGENCY MEDICINE, INC. PROFIT SHARING PLAN 2018 161502502 2019-07-30 UPSTATE EMERGENCY MEDICINE, INC. 83
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 3154644363
Plan sponsor’s address 750 EAST ADAMS STREET, SYRACUSE, NY, 13210

Signature of
Role Plan administrator
Date 2019-07-30
Name of individual signing JANICE HARVEY
Role Employer/plan sponsor
Date 2019-07-30
Name of individual signing GARY JOHNSON
UPSTATE EMERGENCY MEDICINE, INC. PROFIT SHARING PLAN 2017 161502502 2018-07-30 UPSTATE EMERGENCY MEDICINE, INC. 81
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 3154644363
Plan sponsor’s address 750 EAST ADAMS STREET, SYRACUSE, NY, 13210

Signature of
Role Plan administrator
Date 2018-07-30
Name of individual signing GARY A. JOHNSON, M.D.
UPSTATE EMERGENCY MEDICINE, INC. PROFIT SHARING PLAN 2016 161502502 2017-10-13 UPSTATE EMERGENCY MEDICINE, INC. 79
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 3154644363
Plan sponsor’s address 750 EAST ADAMS STREET, SYRACUSE, NY, 13210

Signature of
Role Plan administrator
Date 2017-10-13
Name of individual signing GARY A. JOHNSON, M.D.
Role Employer/plan sponsor
Date 2017-10-13
Name of individual signing GARY JOHNSON
UPSTATE EMERGENCY MEDICINE, INC. PROFIT SHARING PLAN 2015 161502502 2016-10-12 UPSTATE EMERGENCY MEDICINE, INC. 82
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 3154644363
Plan sponsor’s address 750 EAST ADAMS STREET, SYRACUSE, NY, 13210

Signature of
Role Plan administrator
Date 2016-10-12
Name of individual signing GARY A. JOHNSON, M.D.
Role Employer/plan sponsor
Date 2016-10-12
Name of individual signing GARY JOHNSON

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 750 E. ADAMS STREET, SYRACUSE, NY, United States, 13210

History

Start date End date Type Value
1996-06-11 2000-05-11 Address ATTN DR JOHN MCCABE CHAIRMAN, 750 EAST ADAMS STREET, SYRACUSE, NY, 13210, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
000511000348 2000-05-11 CERTIFICATE OF AMENDMENT 2000-05-11
960611000371 1996-06-11 CERTIFICATE OF INCORPORATION 1996-06-11

USAspending Awards. Contracts

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
DELIVERY ORDER AWARD 36C24224N0505 2024-08-01 2025-07-31 2025-07-31
Unique Award Key CONT_AWD_36C24224N0505_3600_36C24224D0044_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 447300.61
Current Award Amount 447300.61
Potential Award Amount 447300.61

Description
Title EMERGENCY DEPARTMENT PHYSICIAN SERVICES WITH EDUCATIONAL AFFILIATE
NAICS Code 611310: COLLEGES, UNIVERSITIES, AND PROFESSIONAL SCHOOLS
Product and Service Codes Q201: MEDICAL- MANAGED HEALTHCARE

Recipient Details
Recipient UPSTATE EMERGENCY MEDICINE, INC.
UEI HAEKW1AKZ5P8
Recipient Address UNITED STATES, 750 E ADAMS ST, SYRACUSE, ONONDAGA, NEW YORK, 132102342
No data IDV 36C24224D0044 2024-08-01 No data No data
Unique Award Key CONT_IDV_36C24224D0044_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 0.00
Potential Award Amount 2374779.69

Description
Title EMERGENCY DEPARTMENT PHYSICIAN SERVICES WITH EDUCATIONAL AFFILIATE
NAICS Code 611310: COLLEGES, UNIVERSITIES, AND PROFESSIONAL SCHOOLS
Product and Service Codes Q201: MEDICAL- MANAGED HEALTHCARE

Recipient Details
Recipient UPSTATE EMERGENCY MEDICINE, INC.
UEI HAEKW1AKZ5P8
Recipient Address UNITED STATES, 750 E ADAMS ST, SYRACUSE, ONONDAGA, NEW YORK, 132102342
DELIVERY ORDER AWARD 36C24224N0261 2024-02-01 2024-07-31 2024-07-31
Unique Award Key CONT_AWD_36C24224N0261_3600_36C24219D0008_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 225000.00
Current Award Amount 225000.00
Potential Award Amount 225000.00

Description
Title REDUCE EXCESS FUNDING ED PHYSICIANS
NAICS Code 611310: COLLEGES, UNIVERSITIES, AND PROFESSIONAL SCHOOLS
Product and Service Codes Q201: MEDICAL- MANAGED HEALTHCARE

Recipient Details
Recipient UPSTATE EMERGENCY MEDICINE, INC.
UEI HAEKW1AKZ5P8
Recipient Address UNITED STATES, 750 E ADAMS ST, SYRACUSE, ONONDAGA, NEW YORK, 132102306
No data IDV 36C24219D0008 2019-02-01 No data No data
Unique Award Key CONT_IDV_36C24219D0008_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 0.00
Potential Award Amount 6347840.82

Description
Title ADD KEY PERSONNEL- ED PHYSICIANS
NAICS Code 611310: COLLEGES, UNIVERSITIES, AND PROFESSIONAL SCHOOLS
Product and Service Codes Q201: MEDICAL- MANAGED HEALTHCARE

Recipient Details
Recipient UPSTATE EMERGENCY MEDICINE, INC.
UEI HAEKW1AKZ5P8
Recipient Address UNITED STATES, 750 E ADAMS ST, SYRACUSE, ONONDAGA, NEW YORK, 132102306
DELIVERY ORDER AWARD 36C24223N0294 2023-02-01 2024-01-31 2024-01-31
Unique Award Key CONT_AWD_36C24223N0294_3600_36C24219D0008_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 508635.60
Current Award Amount 508635.60
Potential Award Amount 508635.60

Description
Title REDUCE EXCESS FUNDING ED PHYSICIANS
NAICS Code 611310: COLLEGES, UNIVERSITIES, AND PROFESSIONAL SCHOOLS
Product and Service Codes Q201: MEDICAL- GENERAL HEALTH CARE

Recipient Details
Recipient UPSTATE EMERGENCY MEDICINE, INC.
UEI HAEKW1AKZ5P8
Recipient Address UNITED STATES, 750 E ADAMS ST, SYRACUSE, ONONDAGA, NEW YORK, 132102306
DELIVERY ORDER AWARD 36C24218N0017 2018-09-25 2018-09-30 2018-12-31
Unique Award Key CONT_AWD_36C24218N0017_3600_VA52813D0129_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 1108244.32
Current Award Amount 1108244.32
Potential Award Amount 1108244.32

Description
Title ED SERVICES
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q201: MEDICAL- GENERAL HEALTH CARE

Recipient Details
Recipient UPSTATE EMERGENCY MEDICINE, INC.
UEI HAEKW1AKZ5P8
Legacy DUNS 077801079
Recipient Address 750 E ADAMS ST, SYRACUSE, ONONDAGA, NEW YORK, 132102306, UNITED STATES
DELIVERY ORDER AWARD VA24217J0246 2016-10-01 2017-08-31 2018-08-31
Unique Award Key CONT_AWD_VA24217J0246_3600_VA52813D0129_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title ED SERVICES IGF::CL::IGF
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q201: MEDICAL- GENERAL HEALTH CARE

Recipient Details
Recipient UPSTATE EMERGENCY MEDICINE, INC.
UEI HAEKW1AKZ5P8
Legacy DUNS 077801079
Recipient Address 750 E ADAMS ST, SYRACUSE, ONONDAGA, NEW YORK, 132102306, UNITED STATES
DO AWARD VA52815J1223 2015-09-01 2016-08-31 2018-08-31
Unique Award Key CONT_AWD_VA52815J1223_3600_VA52813D0129_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title ED SERVICES IGF::CL::IGF
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q201: MEDICAL- GENERAL HEALTH CARE

Recipient Details
Recipient UPSTATE EMERGENCY MEDICINE, INC.
UEI HAEKW1AKZ5P8
Legacy DUNS 077801079
Recipient Address 750 E ADAMS ST, SYRACUSE, ONONDAGA, NEW YORK, 13210, UNITED STATES OF AMERICA
DO AWARD VA52815J0011 2014-09-01 2015-08-31 2018-08-31
Unique Award Key CONT_AWD_VA52815J0011_3600_VA52813D0129_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title ED SERVICES IGF::CL::IGF
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q201: MEDICAL- GENERAL HEALTH CARE

Recipient Details
Recipient UPSTATE EMERGENCY MEDICINE, INC.
UEI HAEKW1AKZ5P8
Legacy DUNS 077801079
Recipient Address 750 E ADAMS ST, SYRACUSE, ONONDAGA, NEW YORK, 13210, UNITED STATES OF AMERICA
DO AWARD VA52814J0201 2014-09-16 2014-09-30 2018-08-31
Unique Award Key CONT_AWD_VA52814J0201_3600_VA52813D0129_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title ED SERVICES IGF::CL::IGF
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q201: MEDICAL- GENERAL HEALTH CARE

Recipient Details
Recipient UPSTATE EMERGENCY MEDICINE, INC.
UEI HAEKW1AKZ5P8
Legacy DUNS 077801079
Recipient Address 750 E ADAMS ST, SYRACUSE, ONONDAGA, NEW YORK, 13210, UNITED STATES OF AMERICA

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
16-1502502 Corporation Unconditional Exemption 750 E ADAMS ST, SYRACUSE, NY, 13210-2306 1997-02
In Care of Name -
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Organization that normally receives no more than one-third of its support from gross investment income and unrelated business income and at the same time more than one-third of its support from contributions, fees, and gross receipts related to exempt purposes 509(a)(2)
Tax Period -
Asset 1,000,000 to 4,999,999
Income 10,000,000 to 49,999,999
Filing Requirement 990 - Not required to file (instrumentalities of states or political subdivisions)
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount -
Income Amount -
Form 990 Revenue Amount -
National Taxonomy of Exempt Entities Health Care: Group Health Practice (Health Maintenance Organizations)
Sort Name -

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3626917100 2020-04-11 0248 PPP 750 East Adams Street, SYRACUSE, NY, 13210-2306
Loan Status Date 2021-07-21
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 2221300
Loan Approval Amount (current) 2221300
Undisbursed Amount 0
Franchise Name -
Lender Location ID 56102
Servicing Lender Name KeyBank National Association
Servicing Lender Address 127 Public Sq, CLEVELAND, OH, 44114-1217
Rural or Urban Indicator U
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address SYRACUSE, ONONDAGA, NY, 13210-2306
Project Congressional District NY-22
Number of Employees 121
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 56102
Originating Lender Name KeyBank National Association
Originating Lender Address CLEVELAND, OH
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 2246555.88
Forgiveness Paid Date 2021-06-11

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Date of last update: 14 Mar 2025

Sources: New York Secretary of State

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