The Threshold Rule: Only Licensees May Own the Practice

New York follows the corporate practice of medicine doctrine. A medical or other professional practice may only be owned by individuals licensed in that profession. In practice, that means your telemedicine practice will operate through a Professional Service Limited Liability Company (PLLC) or a Professional Corporation (PC) — not an ordinary LLC or corporation. An ordinary LLC cannot lawfully deliver professional medical services in New York, and forming the wrong entity type is the most common and most expensive mistake we see practitioners make when they try to set this up themselves or through a generic online formation service.

PLLC or PC — The Entity Decision

For most solo and small-group telemedicine practices, the PLLC is the preferred vehicle: pass-through taxation by default, flexible management through an operating agreement, and fewer corporate formalities. A PC can make sense in specific tax or multi-owner situations. The right answer depends on your ownership plans, your tax posture, and whether other licensees will join later. With an MBA and an LL.M. in Taxation, Attorney Cook evaluates the entity choice as a combined legal and tax decision — not a form-filling exercise.

What New York PLLC Formation Actually Requires

NYSED Certificate of Authority. Before filing anything with the Department of State, a professional entity needs a certificate from the New York State Education Department confirming each owner’s license. This step alone routinely takes longer than practitioners expect, and errors here stall everything behind them.

Articles of Organization filed with the Department of State, with the professional-entity language New York requires.

The publication requirement. New York LLC Law § 206 requires a newly formed PLLC to publish notice of its formation in two newspapers designated by the county clerk of the county where the office is located, once a week for six consecutive weeks, then file a Certificate of Publication. Miss it, and the entity’s authority to carry on business is suspended. Publication costs vary dramatically by county — a strategic consideration we address at formation, not after.

An operating agreement that addresses ownership, management, what happens if an owner loses a license, dies, or departs, and — for multi-owner practices — buy-sell terms. If practitioners later stop getting along, the operating agreement determines everything; see our page on medical practice business divorce for what happens when it was never drafted properly.

EIN, banking, and tax elections — including whether an S-election makes sense for your numbers.

For the formation mechanics in more detail, see our New York PLLC formation page.

Out-of-State Practitioners: You Need a New York License

Telemedicine is deemed delivered where the patient is located. To treat New York patients by telemedicine, you must be licensed in New York — regardless of where you sit. New York has not joined the Interstate Medical Licensure Compact; although IMLC legislation has been introduced in Albany in multiple sessions, it has not been enacted. An out-of-state physician should plan on obtaining a standard New York medical license through NYSED — by examination or endorsement — before treating New York patients. Other professions have their own NYSED endorsement routes. Licensure comes first; the entity is built around it. We help out-of-state practitioners sequence both correctly.

The New York Telehealth Compliance Overlay

Once the entity exists, New York’s telehealth framework governs how you practice. Public Health Law Article 29-G defines telehealth and its permitted modalities. New York’s parity law generally requires commercial insurers and Medicaid to cover telehealth services comparably to in-person care. The standard of care for a telemedicine visit is the same as an office visit — including when a virtual encounter is clinically inappropriate and requires in-person referral. Patient consent, encounter documentation, HIPAA-compliant platforms, and — if you will prescribe — the federal and state rules on remote prescribing (including controlled-substance restrictions) all need policies behind them. We flag these at formation so the practice launches with the compliance architecture in place, not bolted on after a problem.

How Our Office Helps

We advise on the PLLC-versus-PC decision with the tax analysis included. We obtain the NYSED Certificate of Authority, file the Articles of Organization, manage the § 206 publication and Certificate of Publication, draft an operating agreement built for a professional practice, and handle EIN and tax elections. For out-of-state practitioners, we coordinate the licensure sequence with the entity build. And because the firm also handles healthcare law, business law, and tax matters, the practice you form has counsel for what comes after formation — contracts, disputes, and tax questions included.

What to Think About Before You Call

Which profession are you licensed in, and in which states? Do you hold a New York license now, or will you need one? Solo, or will other licensees co-own? Where will the entity’s office be located (this drives publication cost)? Will you prescribe — and controlled substances or not? Will you bill insurance, Medicaid, or run cash-pay? Are you planning to use a third-party telehealth platform, and have you reviewed its contract?

Frequently Asked Questions

Can I use a regular LLC for my telemedicine practice?

No. New York requires licensed professions to practice through a professional entity — a PLLC or PC owned by licensees. A standard LLC cannot lawfully provide medical or other professional services in New York.

I’m licensed in another state. Can I treat New York patients remotely?

Not without a New York license. The service is deemed rendered where the patient is located, and New York has not joined the Interstate Medical Licensure Compact — the standard NYSED licensure process (including licensure by endorsement) applies. Plan the licensure timeline before building the entity.

How long does formation take?

The NYSED Certificate of Authority is usually the longest step, followed by the six-week publication period. Realistic planning is measured in weeks to a few months depending on NYSED processing — not days, no matter what an online formation service advertises.

What happens if I skip the publication requirement?

Under LLC Law § 206, the PLLC’s authority to carry on business is suspended until publication is completed and the Certificate of Publication is filed. It is curable, but it is a real defect — and one payors, lenders, and counterparties do check.

I’m not a clinician — can I own a telehealth company that hires doctors?

Not by owning the medical practice itself. New York’s professional-ownership rules restrict practice ownership to licensees. Structures exist in which a management company provides non-clinical services to a practitioner-owned practice, but they must be built carefully to respect those rules. That is a different engagement — call us before committing to any structure.

Why Choose Ronald S. Cook, P.C.

Attorney Ronald S. Cook holds a J.D., dual LL.M. degrees in Taxation and Bankruptcy, and an MBA, and has practiced in New York for over 25 years. He is a 2025–2026 New York Super Lawyers selectee. Forming a telemedicine practice sits at the intersection of professional-entity law, tax, and healthcare regulation — and this firm handles all three, so the entity decision, the tax election, and the compliance overlay are evaluated together.

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Last reviewed by Attorney Ronald S. Cook — July 2026

This page is for informational purposes only and does not constitute legal advice. Prior results do not guarantee a similar outcome.