New York has 50 direct primary care practices in NextMD's directory. That is only 13 percent of the 381 physician-led membership practices we list across the state. Among the six states with the most practices in our directory, New York has the lowest share using the direct primary care model.
The reasons are practical. A New York doctor who wants to offer direct primary care (DPC) faces high operating costs, state rules for in-office laboratory testing, and a 72-hour limit on dispensing most medications from the office.[7][8][9] These constraints make a low-fee membership practice harder to operate, particularly in New York City.
Laura Petrescu, MD, founded the New York State Direct Care Physicians Alliance in 2026 to help physicians work through those barriers and advocate for changes.[1][2] Petrescu is an internist who opened the first DPC practice in the Rochester metro, according to her practice.[5]
Here is the short version:
For patients: DPC exists in New York, but your options depend heavily on where you live. The median published fee in NextMD's New York DPC listings is $135 per month.
For physicians: In-office testing and medication dispensing require more planning than they do in many other states. Rent and malpractice costs can also require a larger patient panel.
What may change: The new statewide alliance is organizing physician education, practice support, and legislative advocacy.[2]
This article explains each issue, who is working on it, and how you can find a DPC doctor in New York today.
What Direct Primary Care Is
Direct primary care is a membership model. You pay a primary care practice a flat monthly fee, and the practice does not bill insurance for routine visits. Membership commonly includes longer appointments, direct communication with the doctor, and same-day or next-day availability.[4][6]
You still need insurance for hospital care, specialists, imaging, and other services outside the membership.[6]
Nationally, the DPC Alliance's 2024 survey of 465 physicians found an average membership fee of $98.46 per month.[12] In NextMD's directory, the median published fee across New York DPC practices is $135 per month. Athena Direct Primary Care & Lifestyle Medicine in Pittsford charges $149 per month plus a one-time $250 enrollment fee.[6]
Four Barriers for Direct Primary Care in New York
1. In-office testing requires state approval
New York requires a state permit to own or operate a clinical laboratory that accepts specimens from New York.[8] The New York State Department of Health's Wadsworth Center runs the permit program alongside the federal Clinical Laboratory Improvement Amendments (CLIA) requirements.[9][10]
A physician-owned practice that tests only its own patients can apply for a federal CLIA certificate through the state's Physician Office Laboratory Evaluation Program.[10] A practice that performs only waived tests, such as rapid strep testing or a urine dipstick, can register as a Limited Service Laboratory. The registration costs $200, takes at least three weeks to process, and covers only the tests listed on its certificate.[11]
Testing beyond that limited list falls under the full Clinical Laboratory Evaluation Program. Each facility that performs this testing needs its own New York clinical laboratory permit.[8][9] A solo DPC doctor may therefore need to send routine blood samples to an outside laboratory instead of processing them in the office.
Petrescu called laboratory restrictions the alliance's main policy concern on the My DPC Story podcast. She said one board member is leading its work on physician office laboratories.[1]
2. Most physician-dispensed medications are limited to 72 hours
New York Education Law section 6807 generally limits a prescriber who does not own or work for a pharmacy to dispensing a 72-hour supply.[7]
The statute includes nine exceptions. Two apply directly to DPC: a physician may provide medication at no charge or may dispense from a practice at least ten miles from a registered pharmacy.[7] The first option leaves the practice to absorb the cost. The second excludes practices in areas with a nearby pharmacy.
Many DPC practices in other states buy common medications at wholesale prices and dispense them to members at cost.[4] A New York practice generally needs to send a prescription to a pharmacy instead. Petrescu said physicians have workable alternatives for medications, which is why the alliance is prioritizing laboratory rules.[1]
3. Employment contracts can restrict where a doctor opens
Petrescu's health-system employment contract included a two-year non-compete covering a 10-mile radius. She brought the issue to a health-system vice president and secured an addendum that reduced the restricted area to five miles. She then opened her office outside that boundary.[1]
Her experience offers a practical lesson for physicians considering DPC: read your employment agreement before choosing an address. A direct conversation with the employer may create a path forward.
4. New York City operating costs require more members
A DPC practice depends on fixed membership revenue. Higher rent and malpractice costs increase the number of members a doctor needs before the practice can cover its expenses.
Rent. Manhattan office space listed at an average of $71.95 per square foot in July 2026, against a national average of $33.58.[13] A 1,200-square-foot office that costs about $40,000 a year in a typical US market costs roughly $86,000 a year in Manhattan at those rates.
Malpractice. State-filed rates average $23,684 a year for a New York internist with no surgery and $25,227 for a family physician at $1 million/$3 million coverage limits.[14] The figures are before discounts and vary by county.
A DPC doctor charging $135 per month would need about 53 members to cover the example Manhattan rent alone. Malpractice at the internist rate would require revenue from roughly 15 more members. That is before staff, technology, supplies, or the doctor's own pay.
The numbers that result
The DPC Alliance's national survey shows where DPC clusters. The South accounted for 46.5 percent of responses. The Northeast accounted for 15.3 percent. New York did not appear in the top 10 states, and the report noted that states with major metropolitan areas tend to have fewer DPC practices relative to population.[12]
NextMD's directory data tells the same story for New York:
New York lists 381 physician-led practices, the fourth-largest state total.
Only 50 of those are DPC, about 13 percent.
Concierge practices make up 271 of the 381.
Texas, by comparison, has 200 DPC practices out of 609, and Florida has 157 out of 739.
New York has the physician supply and the patient density. Its 13 percent DPC share is the lowest of the six largest states in NextMD's directory.
Who Is Organizing
Laura Petrescu, MD
Laura Petrescu, MD is the founder and CEO of Athena Direct Primary Care & Lifestyle Medicine at 30 Office Park Way in Pittsford, a suburb of Rochester. She is board certified in internal medicine, lifestyle medicine, and menopause medicine, and her practice website describes Athena as the first DPC practice in the Rochester metro.[5] Carl Covey, MD, a family physician with a sports medicine qualification, also sees patients at the practice.[5]
On the podcast, Petrescu said she was the only DPC physician in the Rochester area when she opened during the pandemic, and that awareness among both patients and local physicians was near zero. She spent her first two years giving talks at libraries and community clubs. Over about five years, she said, the metro went from one DPC practice to seven or eight.[1] NextMD's directory currently lists six DPC practices in the Rochester area, including Athena, Planted Direct Primary Care in East Rochester, and Apex Health in Pittsford.
The New York State Direct Care Physicians Alliance
The alliance's stated mission is to advance direct patient care across New York by empowering physicians and advocating for policies that strengthen the doctor-patient relationship. Its three objectives are education, advocacy for statewide legislative change, and physician support.[2] The homepage counts more than 70 direct care practices and roughly 25,000 patients served in New York State.[2]
The alliance covers direct specialty care as well as primary care. Its site describes both models and names neurology, cardiology, dermatology, and endocrinology as specialties where physicians have stepped outside insurance networks.[4]
Petrescu said on the podcast that she filed the incorporation paperwork herself early in 2026, made mistakes on the forms, and lost about three months to corrections. She chose a 501(c)(6) business league structure over a 501(c)(3) charity because the business-league form allows advocacy with the legislature.[1] She said she recruited board members from Buffalo, Syracuse, New York City, and the Hudson Valley so the group would not be a Rochester-only voice.[1]
Catherine Agacola, MD, an upstate New York DPC physician who has appeared on My DPC Story, is a founding board member.[1] The vice president is a neurologist who runs a direct specialty practice, which Petrescu pointed to as evidence that the alliance is for specialists too.[1]
Membership is open now. Physician founders pay $150 per year, physician members $250, and medical students and residents join free. Both physician categories are limited to MDs and DOs.[3] The board votes by email, and Petrescu said the next steps are weekly webinars for physicians considering DPC and a toolkit for opening a practice.[1]
The national network behind it
Maryal Concepcion, MD, a family physician and DPC owner in California, hosts My DPC Story. She described California's path: monthly meetings that faded, then a state summit that drew about 80 physicians. Her team now helps other states run summits, and Petrescu said a New York summit is her next goal.[1]
How to Find a DPC or Concierge Doctor in New York
If you are a New York patient, here is how to search.
Start with the state page. NextMD's New York page lists every physician-led concierge and DPC practice in the state, sortable by city and model.
Check your metro. Upstate patients can use the Rochester page. Downstate patients can use the New York City metro page. Rochester, Pittsford, Fairport, Syracuse, Latham, and Clifton Park all have at least one DPC practice in NextMD's data.
Filter by model. DPC is the membership model with monthly fees typically between $100 and $200. Concierge practices in New York charge more and often still bill insurance for visits. If you want the lower-cost option, filter for DPC.
Read the practice profile. NextMD profiles list the physicians, their degrees, and published pricing. Athena's profile is at nextmd.ai/practice/athena-direct-primary-care-lifestyle-medicine. Planted Direct Primary Care is another Rochester-area option.
Book a meet-and-greet. Most DPC practices offer a free introductory visit. Athena offers a 30-minute meet-and-greet before enrollment.[5]
Ask about labs and medications. Because of the rules above, ask a New York DPC practice where your blood work is drawn and how they handle routine prescriptions. The answer will be different from a practice in Texas.
If nothing turns up within driving distance, search NextMD by zip code. Many New York practices offer telemedicine visits to members.
For background on what the model costs, read DPC vs. traditional primary care: a real cost comparison and the beginner's guide to direct primary care.
What a New York Physician Should Take From This
If you are a New York physician thinking about DPC, three points stand out from the episode.
First, the rules are real but workable. Dozens of New York physicians already run DPC or direct specialty practices under the current lab and dispensing law.[2] The alliance exists to make it easier, not to wait for it to become easy.
Second, read your employment contract. Petrescu's release from a 10-mile non-compete came from a direct conversation, not a lawsuit.[1]
Third, the community now exists. Today there is a New York organization with a membership form, a board across the state, and a legislative agenda.[1][3]
Frequently Asked Questions
Is direct primary care legal in New York?
Yes. DPC practices operate across the state, and the New York State Direct Care Physicians Alliance counts more than 70 direct care practices in New York.[2] The practical differences are the lab permit requirement and the 72-hour limit on physician dispensing.[7][8]
Why can't my New York DPC doctor give me a month of medication?
New York Education Law section 6807 limits a physician who is not a pharmacy owner or employee to dispensing a 72-hour supply, with exceptions for drugs given at no charge and for practices ten miles or more from a pharmacy.[7] Most DPC practices in New York send prescriptions to a pharmacy instead.
Can a New York DPC practice do blood work in the office?
Only with the right state registration or permit. Waived tests can be done under a Limited Service Laboratory registration.[11] Anything more requires a full clinical laboratory permit from the Wadsworth Center.[8][9] Many practices draw blood in the office and send it to a permitted reference lab.
How much does DPC cost in New York?
The national average membership fee in the DPC Alliance's 2024 survey was $98.46 per month.[12] The median published fee among New York DPC practices in NextMD's directory is $135 per month. Athena in Pittsford charges $149 per month.[6]
What is the New York State Direct Care Physicians Alliance?
A physician organization founded in 2026 by Laura Petrescu, MD to support, promote, and advance direct care models in New York, including advocacy for legislative change.[1][2] Physician membership is open to MDs and DOs.[3]
Find a Direct Primary Care or Concierge Doctor in New York
NextMD lists physician-led concierge and direct primary care practices across New York, from Manhattan to Rochester and Buffalo. Browse the New York state page, compare pricing and credentials, and book a visit directly with the practice. Search by zip code at nextmd.ai/search.
This article provides general educational information and is not medical or legal advice. Physicians should consult a New York health care attorney before changing how their practice handles laboratory testing or medication dispensing.
Sources
Concepcion, M. (Host). (2026, August 23). How to Start a State DPC Alliance: Direct Primary Care in New York with Dr. Laura Petrescu. My DPC Story. Listen to the episode
New York State Direct Care Physicians Alliance. (2026). About the Alliance, mission, vision, and objectives. View the alliance homepage
New York State Direct Care Physicians Alliance. (2026). Join Us: membership categories. View the membership page
New York State Direct Care Physicians Alliance. (2026). Direct Care: What is it? Direct Primary Care and Direct Specialty Care. Read the alliance's explainer
Athena Direct Primary Care & Lifestyle Medicine. (2026). Homepage: physicians and approach. View the Athena homepage
Athena Direct Primary Care & Lifestyle Medicine. (2026). Direct Primary Care Membership: pricing and FAQ. View the Athena membership page
New York State Senate. (2025). Education Law section 6807: Exempt persons; special provisions. Read the statute
New York State Senate. (2014). Public Health Law section 574: Permits. Read the statute
New York State Department of Health, Wadsworth Center. (2026). Clinical Laboratory Evaluation Program. View the CLEP page
New York State Department of Health, Wadsworth Center. (2026). Physician Office Laboratory Evaluation Program. View the POLEP page
New York State Department of Health, Wadsworth Center. (2026). Limited Service Laboratories. View the Limited Service Laboratory page
Qiu, K., Bernard, R., O'Rourke, E. (2026, July). State of Direct Primary Care Report. Direct Primary Care Alliance. Read the report (PDF)
Ginsac, I. (2026, August 20). U.S. Office Market Report August 2026: More Office Markets See Dip in Vacancy, Pipeline Remains Modest, Medical Office Space Trends Toward Growth. CommercialCafe. Read the national office report
Gallagher Malpractice. (2026). New York Medical Malpractice Insurance Overview: rates by specialty at $1M/$3M limits. View the New York rate table