The Exigence Team
Exigence has assembled a deep pool of talent including active physicians, experienced hospital administrators, functional experts, managers and entrepreneurs who listen, delve into data, imagine possibilities and partner to develop creative, custom healthcare solutions.
EXIGENCE DIVISION OF TEAMHEALTH Leadership Team
Gregory F. Daniel, MD, MBA
President, Exigence Division of TeamHealth
As president of Exigence Division of TeamHealth, Dr. Daniel works closely with our clients to ensure healthy business relationships. He is responsible for all aspects of the division’s business, including financial solvency, physician relations, revenue generation, marketing, corporate development, and shareholder and client relations.
With more than 20 years of experience as an emergency physician and an MBA degree, Dr. Daniel brings a unique mix of skill, experience, knowledge, and a keen business sense to his role as president of Exigence Division of TeamHealth. In 2000 Dr. Daniel founded The Exigence Group and he served as the group’s CEO until 2012 when The Exigence Group joined TeamHealth. Under Dr. Daniel’s guidance, Exigence expanded its footprint, enhanced its reputation, and became known for strong management and fiscal responsibility. With attention to detail and an eye on the future, he stressed the importance of innovation within the organization to meet emerging client needs.
As CEO of Exigence, Dr. Daniel personally directed a number of development efforts including successful contract negotiations with HMOs, establishment and implementation of operational policies and procedures, and the design and implementation of a partnership tract for Exigence professionals. He introduced numerous innovations and efficiencies, including identifying strategic expansion opportunities and the introduction of incentive structures with specific criteria for attainment and measurement.
Business First Buffalo named Dr. Daniel to the 2010 Healthcare 50 list, which highlights up to 50 movers, innovators, strategists, outstanding caregivers and pioneers in this dynamic sector of the local economy. The Buffalo Niagara Partnership also honored Exigence and Dr. Daniel with their New Minority Business of the Year Award in 2006.
Dr. Daniel earned his doctorate of medicine and a bachelor’s degree in biochemistry from the University of Wisconsin, Madison, and is licensed to practice medicine in eight states. He earned his MBA from the University of California, Irvine, and was named “Best Leader” for his class. Dr. Daniel also received the 2005 Business Leadership Buffalo Niagara award.
He was a member of the board of governors for the Catholic Independent Practice Association of Western New York, (now known as Catholic Medical Partners) for 10 years, where he served on the negotiation and compensation and utilization committees. He served as a flight surgeon in the U.S. Air Force Reserves, retiring at the rank of Major.
Clifton M. Bergfeld, Esq.
Assistant Counsel & Director of Special Projects
Clifton Bergfeld joined Exigence in September 2009. In his current role, Mr. Bergfeld is the Assistant Counsel and Director of Special Projects. Mr. Bergfeld’s diverse background includes litigation, finance, financial planning, recruiting and sales. As an Assistant Counsel he offers support in the areas of corporate compliance, labor law, contracts, government relations and business development. He also manages a number of special projects including the opening of several new Immediate Care facilities.
Mr. Bergfeld began his career as a Financial Advisor for UBS Financial Services in Chicago, Illinois. He and a partner built a successful practice, managing in excess of $75 million in personal and corporate assets with a focus on providing clients comprehensive financial plans. Mr. Bergfeld understands the value of continuing education to maintain a competitive edge and he has received various internal awards and designations along with acquiring a Certificate in Financial Planning from DePaul University and the College of Financial Planning.
Mr. Bergfeld graduated with Highest Distinction from University at Buffalo’s Political Science Honors Program with a B.A. in 2001 and he received his J.D. from UB in 2008. He has experience in representing medical professionals in the areas of corporate formation, contract negotiations and litigation. He currently serves as an Executive Board Member for both the Erie County Medical Center LifeLine Foundation and the University at Buffalo Alumni Association, and is active in various other professional organizations.
Jennifer Blackchief, MBA
Director of OperationsAs Director of Operations, Jennifer oversees all Exigence business units and serves dually as the practice manager for several large emergency room and hospitalist contracts.
Jennifer came to Exigence with over a decade of experience in the healthcare industry, including emergency medical services and longterm care administration. Additionally, Jennifer is a fifteen year veteran firefighter and EMS Captain for Union Fire Company in West Seneca. In this role she not only directly responds to those in need in the community, but spearheads training and certification efforts for her team.
Jennifer earned Summa Cum Laude degrees at the graduate and undergraduate levels. She holds a Master of Business Administration from Medaille College and a Bachelor of Arts degree from State University of New York at Buffalo. She has been awarded Medaille's Alumni of the Year and Harriett Weber Emergency Services Leadership Award, and has been named to the Business First’s Health Care 50 list.
Her tireless commitments extend to a senior education program, Revitalize, which she created nearly 15 years ago and she continues to run today. She also remains active in Medaille Alumni activities and co-chairs their major fundraiser for scholarship and endowment pursuits. Jennifer also participates in statewide efforts to improve the standards of care for the elderly through the Western New York Association of Homes and Services for the Aging (WNYAHSA), as well as serving on other not-for-profit boards.
Brian Bobb, MD
Medical Director, Austin Immediate Care
As Medical Director of Austin Immediate Care, Dr. Bobb will oversee the medical and clinical aspects of the center. He will lead a team of physicians, physician assistants, nurses and other clinical support staff by developing and implementing operational and clinical standards based on best practice guidelines for urgent care medicine by representing the vision, mission and core values of the organization.
Dr. Brian S. Bobb, M.D., graduated from St. Stephen’s Episcopal School in Austin, Texas in 1993. He received his B.S. in Biology with a minor in Chemistry and graduated Cum Laude from Lyon College in Batesville, Arkansas in 1997. He then earned his MD from The University of Texas Health Science Center Medical School in San Antonio, Texas in 2001 and completed his residency in Family Medicine at The Washington Hospital in Washington, Pennsylvania in 2004, where he was Chief Resident. Following residency, Dr. Bobb earned his Board Certification in Family Medicine and opened a solo practice, where he offered full service family medicine, including obstetrics and pediatrics in Oklahoma.
During this time he also served as supervising physician for CMG Urgent Care and as an ER physician for the Tahlequah City Hospital Emergency Department. He was voted one of the community’s “favorite doctors.” He was awarded the Patterson Decade Award from Lyon College for being the outstanding male alumnus. Subsequently, Dr. Bobb relocated his Family Medicine practice to Dripping Springs, Texas during the summer of 2008 in order to practice alongside his wife, Heather Hodson Bobb, DDS.
Senior Project Manager
Tim Carlo joined Exigence in 2008 as a Senior Accounting Manager, but his abilities to develop and produce results soon found him contributing to the organization in a much different role.
Mr. Carlo has managed the development of our urgent care centers as well as supervised the remodeling and move of our corporate office. He took the real estate projects from inception to completion—buying the land, developing the building plans, facilitating the build out, creating the operational plans and opening the facilities.
Mr. Carlo came to Exigence from M&T Bank, where he held the position of Assistant Vice President in Management Accounting. He was directly responsible for developing the bank's $900 million indirect expense budget and analyzing Strategic Business Units profitability.
Mr. Carlo earned master's and bachelor's degrees in business administration from St. Bonaventure University. He is also a member of the Institute of Management Accountants and a volunteer for Western New York Veteran's Housing Coalition, which provides housing opportunities for Veteran's with need and/or disabilities.
Joseph L. Chow, MD
Medical Director, Western New York Immediate Care
Clinical superiority and patient satisfaction are of utmost concern to Dr. Joseph L. Chow, Medical Director of Western New York Immediate Care (WNYIC). Dr. Chow leads by example—he consistently receives superior patient satisfaction scores with patients oftentimes citing his compassion and care as a primary reason for their positive experiences at our facilities.
Dr. Chow joined our organization in 2007. He organizes and oversees all medical care at WNYIC in Orchard Park, NY.
Dr. Chow is board certified in family practice medicine. He is certified in advanced cardiac life support, advanced trauma life support and pediatric advanced life support. He graduated Summa Cum Laude with a bachelor's degree in biology from the University at Buffalo. He earned his medical doctorate from the University at Buffalo School of Medicine in 1997. Dr. Chow completed his residency in family medicine at the University at Rochester via Strong Memorial Hospital and Highland Hospital.
In addition to his position with WNYIC, Dr. Chow serves as Medical Director and Medical Review Officer for DuPont Industries in Buffalo, NY. He is a Clinical Assistant Professor in the University at Buffalo's Department of Family Medicine.
Dr. Chow serves on Young Physicians Committee of the Erie County Medical Society. He is also a member of the Western New York Physician Advisory Group of Univera Healthcare.
Prior to joining WNYIC, Dr. Chow was a Partner and Treasurer of Springville Pediatrics and Adult Care, LLP. He served as physician for the Gow School, the Springville Griffith Institute and for several group homes.
Edward J. Cosgrove, MD, JD
Medical Director, Western New York Immediate Care
Dr. Edward J. Cosgrove is the medical director of Western New York Immediate Care's Williamsville facility and co-director of a facility in Amherst, NY. Dr. Cosgrove is responsible for setting and maintaining policies for medical care, providing oversight and quality assurance for physicians and staff, assisting with physician recruiting and patient satisfaction.
An original partner in Exigence, Dr. Cosgrove has played a key role in the development of the company. He is board certified in internal medicine with over 10 years' experience working in emergency departments. He is certified in advanced cardiac life support, pediatric advanced life support and advanced trauma life support. A member of the Erie County and the New York State Medical Society along with the American Medical Association, he has also served on committees for the Erie County Medical Society.
He serves as an attending physician in the emergency departments of Sisters of Charity Hospital, St. Joseph Hospital, Kenmore Mercy Hospital, Mercy Hospital of Buffalo, and Olean General Hospital. He has also been a staff physician at Sheehan Memorial Hospital and the Erie County Holding Center and spent time as the team physician for the Canisius High School football team.
In addition to being a physician, Dr Cosgrove is an attorney. He graduated cum laude from the University at Buffalo School of Law in 2000. Admitted to the New York State Bar in 2000, Dr Cosgrove utilizes his law degree in the management of our urgent care operations and as an associate in practice with his family's multispecialty law firm providing expertise on medical-legal issues.
Dr. Cosgrove graduated from the University at Buffalo School of Medicine and Biomedical Sciences in 1994, completing his residency in internal medicine at the University at Buffalo Health Consortium in 1997. He holds a bachelor's degree in English from the University of Notre Dame.
Joseph DiVincenzo, JD
Vice President and General Counsel
Joseph DiVincenzo joined Exigence in 2007 and plays a key role in expanding the business and helping to manage our daily operations.
As corporate counsel, he is primarily responsible for the negotiation and drafting of contracts for Exigence across a number of spectrums. He manages this process for personnel within our organization, doctors who join our team, hospitals with whom we work and insurance companies. It is a pivotal position requiring a broad base of knowledge and skill.
Mr. DiVincenzo's role also encompasses our corporate governance, providing oversight to our entities and others with whom we are contracted. Additionally, he possesses a background in accounting which allows him to examine business contracts and operations from both a legal and fiscal standpoint.
Mr. DiVincenzo specializes in contract law, healthcare, litigation and intellectual property. He has argued cases successfully in New York State and throughout the country. He was successful in an intellectual property trademark case, the results of which have been published multiple times in various journals. In addition to being admitted to practicing law in New York State, Mr. DiVincenzo is also admitted to practice in various federal courts across the U.S.
Prior to taking on this role at Exigence, he worked as counsel for Bausch & Lomb in Rochester, NY. He serviced their global manufacturing and purchasing sector, which deals with operations in both the United States and in Europe. He provided oversight on the drafting and review of contracts, negotiations with prospective business partners and corporate governance.
Mr. DiVincenzo has also worked for the Buffalo firm of Hodgson Russ, where he practiced in their business litigation group and he worked as an accountant with Price Waterhouse. In addition, he previously was a member of the Erie County Board of Ethics.
He earned his law degree from the University at Buffalo. He formerly served as the assistant executive editor of The Buffalo Law Review. In addition, Mr. DiVincenzo received a Special Services Award from the Federal Western District of New York Bench and Bar and a writing award from the National Judges Association.
Salvatore C. Durante, MS, MBA
Manager of Urgent Care Operations
Salvatore started in October, 2010 as Manager of Urgent Care Operations for The Exigence Group. In that capacity he oversees the operations and functions of all Immediate Care centers throughout the country, including Pulse Occupational Occupational Medicine. Salvatore has a Master of Business Administration (MBA) degree, with a concentration in healthcare systems management. He also has a master's degree in Counseling.
Salvatore has over 20 years experience in the healthcare industry – in hospital systems, physician practice management, and nonprofit/healthcare organizations. He has held positions of CFO & COO in a large primary care physician group practice, Chief Administrative Officer for a large behavioral healthcare provider, CFO for a large behavioral healthcare provider, and most recently was CEO of a start-up HMO/PACE provider. Salvatore has also operated his own management consulting practice, specializing in strategic planning and improvement strategies for nonprofit and healthcare organizations.
Nancy Ebling, DO
Vice President of Medical Affairs, Hospitalist Division
As the vice president of medical affairs for our hospitalist division, Dr. Nancy Ebling is leading the way for our managed care services in hospitals.
Dr. Ebling manages our contractual obligations to the hospitals we serve, ensuring that we provide the best possible service for our inpatient care operations. She manages the day-to-day operations of all physician-level services. Providing the highest level of service is job number one for Exigence, to ensure our pattern of growth continues, our name recognition increases and our customers are satisfied.
She joined Buffalo Emergency Associates in 2001 after completing her residency, and has been a key figure in the growth and development of our business ever since. She was promoted to vice president of the Exigence Hospitalist division in February 2007.
With her ambition to maintain first-hand knowledge of the needs of physicians and hospitals, Dr. Ebling also continues to practice medicine. She provides both hospitalist and emergency medicine services.
Dr. Ebling earned a Doctor of Osteopathy from the Lake Erie College of Osteopathic Medicine. She also holds a bachelor's degree from Canisius College. She completed both her internship and her residency in internal medicine at Sisters of Charity Hospital in Buffalo.
Dr. Ebling is a member of the Society of Hospitalist Medicine, the American College of Internal Medicine and the American Osteopathic Association.
John Hobel, CPA
Vice President of FinanceJohn Hobel, CPA, is Vice President of Finance responsible for the Urgent Care Division and Real Estate Holdings Division for The Exigence Group. Mr. Hobel has fifteen years of public accounting experience in both accounting and auditing as well as taxation. In addition, he has two years of private accounting experience as the controller for an enterprise management company where he was responsible for the accounting and financial reporting for a consolidated group of companies as well as financial planning and investment management.
Claire S. Jones, MBA
Chief Marketing Officer
Claire Jones joined Exigence in March 2008. She is responsible for image and marketing, brand development, Web strategy, B-to-B and consumer advertising campaigns, publicity and media relations, competitive intelligence and corporate communication for all entities managed by The Exigence Group.
Ms. Jones has over 20 years of progressive experience in communication and marketing including but not limited to advertising, brand development and management, market research, and search engine marketing, as well as public relations, media relations and crisis communication.
Before joining Exigence, Ms. Jones was the Associate Vice President for College Relations at Buffalo State College, an organization with 1,800 employees, 11,000 students, and a $150 million budget. She led a 15-member team that helped to increase applications to the college 22 percent, increased Web site traffic 400 percent, developed a state-of-the-art electronic internal communication program, produced more than 150 publications annually, and developed an emergency notification system and protocol for the college.
A member of the American Marketing Association, American Advertising Federation, Coalition for Urban and Metropolitan Universities and Council for Advancement and Support of Education, Ms. Jones has published papers and presented at national conferences on communication and marketing issues. In addition, she has received numerous national awards. She is currently a member of the Board of Trustees of the Burchfield Penney Art Center.
Ms. Jones earned a bachelor's degree from Purdue University in Communication and a master's of business administration degree from the University at Buffalo.
Frank Lee, MD, FAAEM, FACEP
Vice President of Medical Affairs
Making the connection between administration and the clinical aspects of our organization is where Dr. Frank Lee, vice president of medical affairs, excels. Providing oversight of all clinical aspects within Exigence makes him a key figure in helping shape our future direction.
Dr. Lee quickly made a name for himself both within and outside of our organization. He was named a full general partner in 2002; three years later, as an Exigence regional director, he provided clinical and administrative expertise for our western region connections. He was named vice president in 2006.
He excels at identifying process improvement opportunities, analysis of processes, and has thorough knowledge in the implementation of electronic medical records systems.
Board certified in emergency medicine, Dr. Lee was named chair of the emergency department at St. Joseph Hospital in 2002, a position he maintains today. He spearheaded an initiative at St. Joseph's called Project Renaissance, which has been met with high praise in the medical community. It featured the implementation of a new electronic medical records system, the first for a private ER in the region. He also led the design of the hospital's new emergency department, which won several design element awards. The success of that effort has been measured in improvements in the patient length of stay, patient satisfaction, and increased volume.
St. Joseph Hospital recently honored Dr. Lee with the Caritas Award that recognizes outstanding service and dedication along with support to the community. He also serves on the hospital foundation's board of directors.
Dr. Lee is a frequent lecturer to medical staffs and organizations on a range of topics related to emergency medicine. He is also certified in ultrasound. Dr. Lee continues to practice emergency medicine at St. Joseph Hospital, Mercy Hospital, Sisters of Charity Hospital, and urgent care facilities. He is also an assistant clinical professor.
He completed his residency at the University at Buffalo's School of Medicine, earning his medical doctorate along with a bachelor's degree in biological sciences from the University at Buffalo.
Irving Levy, CPA
Chief Financial Officer
Bringing more than 20 years of experience to Exigence along with a thorough knowledge of healthcare practice management, Irv Levy serves as Chief Financial Officer, a role he has held since 2005.
His focus on growing the business through successful financial operations returns strong results for our organization and our clients. Mr. Levy is responsible for all accounting and reporting practices, billing and collections, human resources and recruitment of new physicians.
Mr. Levy's keen ability to adapt to the ever-changing business environment and his expertise related to issues in healthcare practice management and administration gives Exigence a CFO who knows what it takes to continuously improve our operations and expand our business. In fact, his reputation in the industry has made him a popular consultant and sought-after speaker on physician practice management issues. He regularly conducts seminars locally and nationwide for the Medical Group Management Association.
His career path and experience has provided Mr. Levy with a strong background in physician practice management. He has been involved with projects involving medical practice profit enhancement, collections enhancements and the structure, sale and acquisition of medical practices.
He joined Exigence after spending 20 years at the regional accounting firm Freed Maxick & Battaglia. He was a managing director in the auditing and accounting department, chaired its physician practice niche, and built its business advisory services division from the ground up. That division accounted for 10 percent of the firm's volume. Mr. Levy spent 13 years as a tax consultant where he managed federal, state and international tax issues for the firm.
During that time he was also a consultant for Exigence where he assisted with building our unique and successful membership model. Both a certified public accountant and a certified financial planner, he began his career at a small accounting firm in Houston, Texas.
Mr. Levy is a graduate of Canisius College. He is a member of the Healthcare Financial Management Association, the American Institute of Certified Public Accountants and the New York State Society of Certified Public Accountants.
Mark Podlas, MD
Medical Director, Western New York Immediate Care
Bio to come
Pamela Sullivan, MD
Medical Director, Rochester Immediate Care
Pam Sullivan, M.D., is a well known emergency medicine physician who has practiced at Rochester General Hospital and Highland Hospital since 1993. She is board certified in internal medicine and with certifications in pediatric advanced life support, advanced trauma life support and advanced cardiac life support.
A New York City native, Dr. Sullivan earned a bachelor’s degree in physical therapy at Ithaca College and her medical degree at the Medical College of Philadelphia; she served an internship and residency in primary care internal medicine at the University of Rochester School of Medicine and Dentistry. While employed by the medical school, she held an academic appointment as senior instructor of clinical emergency medicine.
Dr. Sullivan is a Fellow of the American College of Physicians and serves as a council member and as chair of the membership committee of the New York ACP.
Janet Williams, MD
Medical Director, Rochester Immediate Care
For nearly 20 years, Dr. Janet Williams has provided expert clinical care in a variety of emergency and urgent care settings, both hospital-affiliated and free-standing, in urban and rural areas.
As an attending physician and faculty member in emergency departments and medical schools in Pennsylvania, West Virginia and New York, Dr. Williams has taught residents, physician assistants, and nurse practitioners in clinical emergency medicine and is an acknowledged national leader in the management and provision of clinical care. She is an accomplished clinician as well as a true advocate for patient satisfaction.
Joining Rochester Immediate Care in February of 2010, Dr. Williams oversees all medical care at the new Rochester Immediate Care facility on West Ridge Road in Greece, NY.
Dr. Williams is certified as a Diplomate of the American Board of Emergency Medicine and is an active member of a number of national professional organizations including the American Academy of Urgent Care Medicine.
A Rochester native, Dr. Williams earned her bachelor's degree in mathematics at Bucknell University in 1984 and her medical degree at the University of Buffalo School of Medicine in 1988. She completed a residency in emergency medicine, including tenure as chief resident, at Allegheny General Hospital in Pittsburgh, PA in 1991.
Following residency, Dr. Williams served as an attending physician in emergency departments at Allegheny General Hospital (1991-1992); Ruby Memorial Hospital, Morgantown, WV (1992-2003); and Strong Memorial Hospital, Rochester, NY (2003 – present).
Her current academic appointment is Professor of Emergency Medicine at the University of Rochester School of Medicine and Dentistry. Previous academic appointments were at West Virginia University, Alderson-Broaddus College, and the Medical College of Pennsylvania.
Gerald P. Wohlleber
Vice President of Finance
Gerald P. Wohlleber works closely with the CEO and CFO to provide accurate and timely finance information and assists in maximizing returns on financial assets by establishing financial policies, procedures, controls and reporting systems. Mr. Wohlleber is responsible for overseeing all financial transactions of the companies. He participates in the strategic discussions of new business ventures and opportunities to accelerate growth of the company's core business.
Mr. Wohlleber's is responsible for the management of the company's internal control systems. He acutely monitors and confirms financial condition by conducting internal reviews and providing information to external auditors/accountants. He also manages the activities of the tax compliance department.
Prior to joining the group, Mr. Wohlleber spent over 10 years in public accounting. He obtained a broad background in the manufacturing, construction, wholesale, and general service industries. He managed and supervised the preparation of financial statements and corporate tax returns in a broad range of industry formats including consolidations. He has an extensive background in tax planning, working with closely held businesses, S-Corporations, partnerships and limited liability companies. Along with corporate tax returns, Mr. Wohlleber prepared and reviewed personal tax returns for high net worth individuals and business owners. In addition, Mr. Wohlleber worked on forensic accounting engagements where fraud and embezzlement have occurred.
Mr. Wohlleber is a graduate of State University of New York at Plattsburgh.