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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 (28 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

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
DO AWARD V528C84210 2008-04-01 2008-09-30 2009-09-30
Unique Award Key CONT_AWD_V528C84210_3600_VA528P0073A_3600
Awarding Agency Department of Veterans Affairs
Link View Page

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

Recipient Details
Recipient UPSTATE EMERGENCY MEDICINE, INC.
UEI HAEKW1AKZ5P8
Legacy DUNS 077801079
Recipient Address UNITED STATES, 750 E ADAMS ST, SYRACUSE, 132102306
DO AWARD VA528C94031 2008-10-01 2009-09-30 2009-09-30
Unique Award Key CONT_AWD_VA528C94031_3600_VA528P0073A_3600
Awarding Agency Department of Veterans Affairs
Link View Page

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

Recipient Details
Recipient UPSTATE EMERGENCY MEDICINE, INC.
UEI HAEKW1AKZ5P8
Legacy DUNS 077801079
Recipient Address UNITED STATES, 750 E ADAMS ST, SYRACUSE, 132102306
DO AWARD VA528C04287 2010-09-17 2010-09-30 2010-12-31
Unique Award Key CONT_AWD_VA528C04287_3600_VA528P0747_3600
Awarding Agency Department of Veterans Affairs
Link View Page

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

Recipient Details
Recipient UPSTATE EMERGENCY MEDICINE, INC.
UEI HAEKW1AKZ5P8
Legacy DUNS 077801079
Recipient Address UNITED STATES, 750 E ADAMS ST, SYRACUSE, 132102306
DO AWARD VA528C04014 2009-10-01 2010-06-30 2010-06-30
Unique Award Key CONT_AWD_VA528C04014_3600_VA528P0073A_3600
Awarding Agency Department of Veterans Affairs
Link View Page

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

Recipient Details
Recipient UPSTATE EMERGENCY MEDICINE, INC.
UEI HAEKW1AKZ5P8
Legacy DUNS 077801079
Recipient Address UNITED STATES, 750 E ADAMS ST, SYRACUSE, 132102306
No data IDV VA528P0747 2010-07-01 No data No data
Unique Award Key CONT_IDV_VA528P0747_3600
Awarding Agency Department of Veterans Affairs
Link View Page

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

Recipient Details
Recipient UPSTATE EMERGENCY MEDICINE, INC.
UEI HAEKW1AKZ5P8
Legacy DUNS 077801079
Recipient Address UNITED STATES, 750 E ADAMS ST, SYRACUSE, 132102306
DO AWARD VA528C14064 2011-07-22 2011-09-30 2011-09-30
Unique Award Key CONT_AWD_VA528C14064_3600_VA528P0747_3600
Awarding Agency Department of Veterans Affairs
Link View Page

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

Recipient Details
Recipient UPSTATE EMERGENCY MEDICINE, INC.
UEI HAEKW1AKZ5P8
Legacy DUNS 077801079
Recipient Address UNITED STATES, 750 E ADAMS ST, SYRACUSE, 132102306
DO AWARD VA52812J0234 2012-08-13 2012-09-30 2012-09-30
Unique Award Key CONT_AWD_VA52812J0234_3600_VA528P0747_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title EMERGENCY ROOM PHYSICIANS, SYRACUSE VAMC
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 UNITED STATES, 750 E ADAMS ST, SYRACUSE, 132102306
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

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Date of last update: 13 Nov 2024

Sources: New York Secretary of State

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