2024-06-03T14:47:07-05:00 2023-09-30 042713795 MEYERS BROTHERS KALICKA PC 330 WHITNEY AVE SUITE 800 HOLYOKE MA 01040 990 2022-10-01 813871395 THE MEDICAL STAFF OF COOLEY DICKINSON HOSPITAL INC MEDI 4135822000 30 LOCUST ST NORTHAMPTON MA 01060 PETER CHRISTAKOS TREASURER 4135822000 2024-06-03 1 PETER CHRISTAKOS 999009999 0 JAMES T KRUPIENSKI P01448008 4135368510 2024-06-03 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z PETER CHRISTAKOS 30 LOCUST ST NORTHAMPTON MA 01060 297713 0 X WWW.COOLEYDICKINSON.ORG X 2016 MA TO COLLABORATE WITH COOLEY DICKINSON HOSPITAL IN PROVIDING SAFE, QUALITY PATIENT CARE. 25 20 0 25 0 0 0 0 40100 297477 720 236 0 0 40820 297713 6500 0 0 0 70750 75738 26250 0 0 26514 61387 130014 137125 -89194 160588 223134 383722 0 0 223134 383722 THE SELF-GOVERNING MEDICAL STAFF OF COOLEY DICKINSON HOSPITAL IN COLLABORATION WITH THE COOLEY DICKINSON HOSPITAL BOARD OF TRUSTEES AND ADMINISTRATION WILL WORK TO PROVIDE SAFE, QUALITY PATIENT CARE. 0 0 122975 288977 PROVIDED EDUCATIONAL & QUALITY IMPROVEMENT ACTIVITIES FOR MEMBERS OF THE MEDICAL STAFF OF COOLEY DICKINSON HOSPITAL AND ALL OTHERS WITH DELINEATED PRIVILEGES AT COOLEY DICKINSON HOSPITAL. PROVIDED A COLLEGIAL AND GOVERNING BODY FOR COOLEY DICKINSON HOSPITAL TO ENSURE A HIGH LEVEL OF PROFESSIONAL PERFORMANCE BY ALL MEMBERS OF THE MEDICAL STAFF THROUGH AN ONGOING REVIEW & EVALUATION OF EACH MEMBER'S PERFORMANCE. 14150 8500 THE CONTINUING MEDICAL EDUCATION PROGRAM (CME) IS AN EDUCATIONAL PROGRAM DIRECTED TOWARD ENHANCING BOTH THE MEDICAL KNOWLEDGE AND THE SKILLFUL FUNCTIONING OF THE PHYSICIAN STAFF. IT RECEIVES ACCREDITATION FROM THE MASS MEDICAL SOCIETY WHICH IS ITSELF ACCREDITED BY THE ACCREDITATION COUNCIL FOR CONTINUING MEDICAL EDUCATION. THE PROGRAM OFFERS ABOUT 60 LIVE EDUCATIONAL PROGRAMS PER YEAR INVITING EXPERT SPEAKERS FROM THIS HOSPITAL, MASS GENERAL HOSPITAL, AND OTHER AREA HOSPITALS. PHYSICIANS ARE ABLE TO COUNT PARTICIPATION IN THESE PROGRAMS TOWARD THE BOARD OF REGISTRATION IN MEDICINE'S REQUIREMENTS FOR RE-LICENSURE. 137125 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 11 0 0 0 0 0 0 0 0 0 0 0 0 X 25 20 1 0 0 0 1 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 MA X PETER CHRISTAKOS 4135822000 30 LOCUST ST NORTHAMPTON MA 01060 MICHELLE HELMS MD PRESIDENT 6.00 X X 5000 0 0 REBECCA STARR MD VICE PRESIDENT 2.00 X X 0 0 0 PETER CHRISTAKOS MD SECRETARY/TREASURER 4.00 X X 4000 0 0 KHAMA ENNIS MD IMMEDIATE PAST PRESIDENT 1.00 X 27300 0 0 JACOB SCHAUER MD DIRECTOR: CHIEF OF ANESTHESIA 1.00 X 0 0 0 PETER ALBANESE DMD DIRECTOR: CHIEF OF DENTISTRY 1.00 X 0 0 0 CAROLYN CANTER MD DIRECTOR: CHIEF OF EMERGENCY MEDICINE 1.00 X 0 0 0 TONBIRA ZAMAN MD DIRECTOR: CHIEF OF MEDICINE 1.00 X 15000 0 0 MELANIE GREENMAN MD DIRECTOR: CHIEF OF OB/GYN 1.00 X 0 0 0 LISA GLANTZ MD DIRECTOR: CHIEF OF PATHOLOGY 1.00 X 0 0 0 HELENA MCCRACKEN MD DIRECTOR: CHIEF OF PEDIATRICS 1.00 X 0 0 0 CATHERINE DURI MD DIRECTOR: CHIEF OF PSYCHIATRY 1.00 X 0 0 0 GREGORY BLACKMAN MD DIRECTOR: CHIEF OF RADIOLOGY 1.00 X 0 0 0 HOLLY MICHAELSON MD DIRECTOR: CHIEF OF SURGERY 1.00 X 10000 0 0 ANGELA MARTAGON-VILLAMIL MD DIRECTOR: HOSPITALIST SERVICE 1.00 X 0 0 0 SOFIA BUFORD NP DIRECTOR: AT-LARGE 1.00 X 0 0 0 STEVEN ESRICK MD DIRECTOR: AT-LARGE 1.00 X 0 0 0 BARRETT NEWSOME MD DIRECTOR: AT-LARGE 1.00 X 0 0 0 GLENN MISKOVSKY MD DIRECTOR: AT-LARGE 1.00 X 0 0 0 LYNETTE WATKINS MD DIRECTOR: EX OFFICIO 1.00 X 0 0 0 ANN LEBRUN DIRECTOR: EX OFFICIO 1.00 X 0 0 0 SARI MIETTINEN MD DIRECTOR: EX OFFICIO 1.00 X 0 0 0 ROBERT LEVINE PA DIRECTOR: EX OFFICIO 1.00 X 0 0 0 BRIAN WILSON DIRECTOR: EX OFFICIO 1.00 X 0 0 0 TANYA RUELL DIRECTOR: EX OFFICIO 1.00 X 0 0 0 61300 0 0 0 0 0 0 0 MEMBERSHIP STAFF DUES 621500 288977 288977 CME REVENUE/REIMBURSEM 621500 8500 8500 297477 236 236 297713 297477 0 236 X 75738 3460 4450 23916 17 11232 853 CME PROGRAM EXPENSE 10250 DUES AND LICENSES 3900 MISCELLANEOUS 3294 ANNUAL REPORT 15 137125 211258 372699 11876 11023 223134 383722 0 0 X 0 0 0 0 223134 383722 223134 383722 223134 383722 160588 0 X 0 0 0 0 1 0 FORM 990, PART VI, SECTION A, LINE 1A THE GOVERNING BODY DELEGATED BROAD AUTHORITY TO AN EXECUTIVE COMMITTEE WHICH PER THE ORGANIZATION'S BYLAWS, IS TO REPRESENT AND ACT, ON BEHALF OF THE MEDICAL STAFF, IN ALL MATTERS BETWEEN MEETINGS OF THE MEDICAL STAFF. FORM 990, PART VI, SECTION A, LINE 2 SOME OF THE OFFICERS AND DIRECTORS OF THE ORGANIZATION SHARE A BUSINESS RELATIONSHIP WITH ONE ANOTHER AS THEY ARE MEDICAL PROFESSIONALS EMPLOYED BY COOLEY DICKINSON HOSPITAL. FORM 990, PART VI, SECTION A, LINE 6 INDIVIDUAL PHYSICIANS,ADVANCE PRACTICE CLINICIANS, PODIATRISTS, DENTISTS AND ORAL SURGEONS WITH PRIVILEGES AT COOLEY DICKINSON HOSPITAL ARE ELIGIBLE FOR MEMBERSHIP IN THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED BY THE TREASURER OF THE MEDICAL STAFF OF COOLEY DICKINSON PRIOR TO IT BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C IN ACCORDANCE WITH COMPANY BYLAWS, IN ANY INSTANCE WHERE A MEMBER OF THE EXECUTIVE COMMITTEE HAS A CONFLICT OF INTEREST IN ANY MATTER INVOLVING ANOTHER MEDICAL STAFF MEMBER WHICH COMES BEFORE THE EXECUTIVE COMMITTEE, OR IN ANY INSTANCE WHERE A MEMBER OF THE EXECUTIVE COMMITTEE BROUGHT THE COMPLAINT AGAINST THAT MEMBER, THAT MEMBER SHALL NOT PARTICIPATE IN THE DISCUSSION OR VOTING ON THE MATTER AND SHALL ABSENT HIMSELF/HERSELF FROM THE MEETING DURING THAT TIME, ALTHOUGH THE MEMBER MAY BE ASKED AND ANSWER QUESTIONS CONCERNING THE MATTER BEFORE LEAVING. FORM 990, PART VI, SECTION C, LINE 18 UPON REQUEST FROM ORGANIZATION FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST FROM ORGANIZATION FORM 990, PART IX, LINE 11G DME STIPEND 23,916.