How to open a medical practice in New York City

The physician is licensed by the State Education Department's Office of the Professions.¹ A private practice is not a Public Health Law Article 28 facility, the hospitals, diagnostic and treatment centers and ambulatory surgery centers the Department of Health licenses, unless it is set up as one.²

• Hold a New York licence for every physician, with the required coursework in child abuse identification and in infection control.¹
• Choose a legal form the law allows. A sole practitioner, a professional corporation whose shareholders, officers and directors are all physicians, or a professional limited liability company whose members and managers are all physicians, among others.²
• Accredit before office-based surgery. Procedures with general anesthesia, moderate or deep sedation, or any liposuction outside a hospital or surgery center need accreditation by an agency the Commissioner of Health designates, AAAHC and the Joint Commission among them, and the process can take many months.³⁴
• Apply for Certificate of Need if you are establishing, building or renovating an Article 28 facility such as a diagnostic and treatment center.⁵
• Register with the DEA in New York. A practitioner's registration rests on a state licence, and DEA requires a separate registration in each state.⁶
• Get an NPI, then enroll. Apply for the National Provider Identifier through NPPES, then enroll in Medicare through PECOS, where most physicians complete the CMS-855I.⁷⁸

• The Joint Commission hub
• Joint Commission office-based surgery accreditation
• Office-based surgery accreditation by state
• The AAAHC hub

That depends on what happens in the rooms. Most procedures such as botulinum toxin injections use minimal or no sedation and can be done in an office without OBS accreditation, while sedation, general anesthesia and liposuction bring the accreditor's survey.²

• Plan for ventilation monitoring. The Department of Health's capnography statement, effective 31 January 2018, sets the standard for patients under moderate sedation, deep sedation or general anesthesia in an office.³
• Follow the liposuction guidance the Department issued on 5 June 2024 for office procedures with and without fat grafting.³
• Have the survey documents ready. The Joint Commission's office-based surgery guide asks for environment of care plans, the hazard vulnerability analysis and the emergency operations plan.⁹
• Build an Article 28 site through Certificate of Need. The amended 10 NYCRR 710.1, in effect since 6 August 2025, sets the review level for construction projects.⁵

• The ambulatory care standards checklist

New York ties its state-funded excess layer to primary cover. A physician certified for the excess program must hold an individual primary policy from an insurer licensed in New York of at least $1 million for each claimant and $3 million for all claimants.¹⁰

• Know where the excess layer comes from. It is bought from a hospital excess liability pool overseen by the Superintendent of Insurance and the Commissioner of Health.¹⁰
• Check the alternative route. A physician endorsed as an additional insured under a hospital's voluntary attending physician program qualifies instead of holding an individual policy.¹⁰
• Write the OBS reporting clock into your claims process. An adverse event after office-based surgery is reported to the Department of Health within three business days of the occurrence of the event, and an unplanned emergency department visit within 72 hours of the procedure counts as one.²

• The AAAHC clinical records guide

Physicians complete infection control training at initial licensure and every four years after.¹¹ Every prescriber with a DEA registration completes three hours in pain management, palliative care and addiction once every three years.¹²

• Verify each licence on the Office of the Professions' online search before the first shift.¹³
• Set up PMP Registry access. Each prescriber and each designee needs an individual Health Commerce System account.¹⁴
• Prescribe electronically. Since 27 March 2016 prescriptions in New York, controlled and non-controlled, go electronically to the pharmacy, with limited exceptions.¹⁵
• Know who handles complaints. The Department of Health's Office of Professional Medical Conduct investigates complaints about physicians.¹⁶

• Training a clinic team on AI

A business associate agreement with every vendor that handles patient information, which HIPAA requires.¹⁷ A practice in compliance with HIPAA is treated as meeting the SHIELD Act's duty of reasonable safeguards.¹⁸

• Ask before you record. Penal Law 250.00 treats recording without the consent of at least one party as eavesdropping, and asking the patient is still the right practice.¹⁹
• Answer in the patient's language. 1,810,363 New Yorkers aged five and over speak Spanish at home and 493,448 speak Chinese.²⁰
• Put consent in the booking. Record the patient's consent to an ambient note at booking, so the visit starts with it on file.¹⁹

• Clinic AI in New York City
• US recording laws for AI scribes

The prescribing habits and the reporting clocks. Most prescribers must consult the PMP Registry before writing Schedule II, III or IV controlled substances, and OBS adverse events are reported within three business days of the occurrence of the event.¹⁴²

• Check the registry every time. Designees can run the check on a prescriber's behalf.¹⁴
• Prepare for the accreditor. The Joint Commission surveys an office-based surgery practice on site every three years, a typical survey lasting one day.²¹
• Diary the renewals. Infection control training repeats every four years, prescriber education every three, and Medicare revalidation every five.¹¹¹²⁸
• Trace one patient end to end from booking to follow-up, the way a surveyor does, and fix what the record cannot show.⁹

• The Joint Commission survey process