Skip to content
Nonprofiteer
← SAMARITAN MEDICAL PRACTICE PC

Form 990 for tax year 2023

Filed by SAMARITAN MEDICAL PRACTICE PC.

Totals

Total revenue
$4,838,129
Total expenses
$11,619,655
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$4,838,129
Investment income
$0
Other revenue
$0
Total assets, end of year
$1,713,722
Total liabilities, end of year
$1,713,722
Net assets or fund balances, end of year
$0
Program services expenses (Part IX)
$11,612,985
Management and general expenses
$6,670
Fundraising expenses
$0
Program service expenses (Part III)
$11,612,985

Program services were 99.9% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 2a · Program service revenue: PATIENT SERVICE REVENU

    total $4,838,129 · related or exempt $4,838,129

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $7,916,347 · program services $7,916,347

  • 9 · Other employee benefits

    total $1,290,251 · program services $1,290,251

  • 11c · Fees: accounting

    total $6,670 · management and general $6,670

  • 11g · Fees: other

    total $747,632 · program services $747,632

  • 13 · Office expenses

    total $40,781 · program services $40,781

  • 16 · Occupancy

    total $379,324 · program services $379,324

  • 17 · Travel

    total $5,951 · program services $5,951

  • 19 · Conferences, conventions and meetings

    total $10,495 · program services $10,495

  • 22 · Depreciation, depletion and amortization

    total $46,310 · program services $46,310

  • 23 · Insurance

    total $508,058 · program services $508,058

  • 24a · Other expenses: PROVISION FOR BAD DEBTS

    total $437,491 · program services $437,491

  • 24b · Other expenses: MEDICAL/PHARMACY CHARGE

    total $203,820 · program services $203,820

  • 24c · Other expenses: DUES/MEMBERSHIP/BOOKS

    total $18,206 · program services $18,206

  • 24d · Other expenses: TAXES

    total $3,500 · program services $3,500

  • 24e · All other expenses

    total $4,819 · program services $4,819

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $515,499 · end of year $507,990

  • 4 · Accounts receivable

    beginning of year $784,253 · end of year $505,645

  • 9 · Prepaid expenses and deferred charges

    beginning of year $68,844 · end of year $6,746

  • 10a · Land, buildings and equipment: cost or other basis

    $1,478,503

  • 10b · Land, buildings and equipment: accumulated depreciation

    $1,368,945

  • 10c · Land, buildings and equipment, net

    beginning of year $321,335 · end of year $109,558

  • 15 · Other assets

    beginning of year $185,000 · end of year $583,783

  • 17 · Accounts payable and accrued expenses

    beginning of year $519,854 · end of year $358,797

  • 25 · Other liabilities

    beginning of year $1,355,077 · end of year $1,354,925

Mission and programs · 2023

Mission

THE MISSION OF SAMARITAN MEDICAL PRACTICE PC IS TO SUPPORT THE CHARITABLE PURPOSES OF SAMARITAN MEDICAL CENTER, INC. WHICH INCLUDES PROVIDING PHYSICIAN SERVICES DESIGNED TO IMPROVE THE STANDARDS AND QUALITY OF HEALTHCARE AVAILABLE TO THE RESIDENTS OF JEFFERSON COUNTY AND OTHER AREAS SERVED BY THE HOSPITAL. FURTHERMORE, OUR PURPOSE IS TO PARTICIPATE IN ACTIVITIES TO PROMOTE AND IMPROVE THE OVERALL HEALTH OF, AND MEET THE MEDICAL CARE NEEDS OF THE COMMUNITY.

Activities or mission (Part I)

THE MISSION OF SAMARITAN MEDICAL PRACTICE, P.C. IS TO SUPPORT THE CHARITABLE PURPOSES OF SAMARITAN MEDICAL CENTER WHICH INCLUDES PROVIDING PHYSICIAN SERVICES DESIGNED TO IMPROVE THE STANDARDS AND QUALITY OF HEALTH CARE AVAILABLE TO THE RESIDENTS OF JEFFERSON COUNTY AND OTHER AREAS SERVED BY THE HOSPITAL. FURTHERMORE, OUR PURPOSE IS TO PARTICIPATE IN ACTIVITIES TO PROMOTE AND IMPROVE THE OVERALL HEALTH OF, AND MEET THE MEDICAL CARE NEEDS OF THE COMMUNITY.

  • PROVIDED PROFESSIONAL PHYSICIAN SERVICES IN MEDICAL SPECIALTY AREAS, SUCH AS GENERAL SURGERY, VASCULAR SURGERY, PLASTIC/COSMETIC, AND ORTHOPEDIC SURGERY. A TOTAL OF 23,287 TREATMENTS TO PATIENTS WERE PERFORMED.

    Expenses $11,612,985 · Revenue $4,838,129

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Mario Victoria MD

    PRESIDENT/DIRECTOR

    Total calculated
    $525,890
    From this org
    $0
    From related orgs
    $477,526
    Other
    $48,364
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $416,458 related
    Bonus
    $0 + $40,245 related
    Other
    $0 + $20,823 related
    Deferred
    $0 + $17,300 related
    Nontaxable benefits
    $0 + $31,064 related
    Filer's total
    $0 + $525,890 related

  • Thomas H Carman

    CEO OF SMC/SECRETARY

    Total calculated
    $1,102,663
    From this org
    $0
    From related orgs
    $1,043,591
    Other
    $59,072
    Hours/week
    1 + 43.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $735,218 related
    Bonus
    $0 + $306,133 related
    Other
    $0 + $2,240 related
    Deferred
    $0 + $11,200 related
    Nontaxable benefits
    $0 + $47,872 related
    Filer's total
    $0 + $1,102,663 related

  • Maxine Briggs

    CFO OF SMC/TREASURER

    Total calculated
    $608,072
    From this org
    $0
    From related orgs
    $559,897
    Other
    $48,175
    Hours/week
    1 + 42.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $494,062 related
    Bonus
    $0 + $43,335 related
    Other
    $0 + $22,500 related
    Deferred
    $0 + $17,800 related
    Nontaxable benefits
    $0 + $30,375 related
    Filer's total
    $0 + $608,072 related

  • Eduardo Barayuga

    GENERAL SURGEON

    Total calculated
    $516,161
    From this org
    $478,434
    From related orgs
    $0
    Other
    $37,727
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $390,256
    Bonus
    $88,178
    Other
    $0
    Deferred
    $17,800
    Nontaxable benefits
    $19,927
    Filer's total
    $516,161

  • Deana E Paley

    PLASTIC SURGEON

    Total calculated
    $590,463
    From this org
    $564,342
    From related orgs
    $0
    Other
    $26,121
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $560,571
    Bonus
    $3,771
    Other
    $0
    Deferred
    $17,800
    Nontaxable benefits
    $8,321
    Filer's total
    $590,463

  • Daniel Bryden

    GENERAL SURGEON

    Total calculated
    $546,837
    From this org
    $499,653
    From related orgs
    $0
    Other
    $47,184
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $387,236
    Bonus
    $112,417
    Other
    $0
    Deferred
    $17,800
    Nontaxable benefits
    $29,384
    Filer's total
    $546,837

  • Maurice Tom-Pack

    GENERAL SURGEON

    Total calculated
    $653,405
    From this org
    $629,234
    From related orgs
    $0
    Other
    $24,171
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $629,234
    Bonus
    $0
    Other
    $0
    Deferred
    $17,800
    Nontaxable benefits
    $6,371
    Filer's total
    $653,405

  • Brian Zafonte

    ORTHOPEDIC SURGEON

    Total calculated
    $1,203,799
    From this org
    $1,166,072
    From related orgs
    $0
    Other
    $37,727
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $1,007,864
    Bonus
    $158,208
    Other
    $0
    Deferred
    $17,800
    Nontaxable benefits
    $19,927
    Filer's total
    $1,203,799

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Written employment contract
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 4B
THE FOLLOWING INDIVIDUALS RECEIVED CONTRIBUTIONS TO AN IRC 457(F) PLAN DURING 2023: N/A THE FOLLOWING INDIVIDUALS RECEIVED CONTRIBUTIONS TO AN IRC 457(B) PLAN DURING 2023: MAXINE BRIGGS- $22,500 MARIO VICTORIA- $20,823

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2023
Filed
12 November 2024
IRS schema version
2023v5.1
Source object
202403189349311265

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

The source document this was parsed from is served over the API, which is where bulk and document access live.