Tax Planning for Physicians in Long Island, NY (2026)

Physicians in Long Island pay federal tax at up to 37% plus New York income tax (a top rate of 10.9%), and local rules add another layer. Here is how the 2026 rules apply to doctors, dentists and practice owners in Long Island, NY.

2026 at a glance for Long Island, NY physicians

State tax figures apply New York's 2026 brackets to state taxable income and ignore credits, deductions and local taxes.

Local taxes in Long Island

Long Island residents do not pay New York City income tax unless they live in the city. Nassau and Suffolk counties are in the Metropolitan Commuter Transportation District, and for tax years beginning in 2026 the MCTMT applies to self-employed individuals whose net earnings allocated to the district exceed $150,000 in a zone. Employers in the district also pay MCTMT on payroll.

State rules that apply in Long Island

Yes. The state has an elective pass-through entity tax (PTET) that partnerships and S corporations can use to deduct state income tax at the entity level.

• New York's top rate is 10.9% (on income over $25 million; rates of 9.65% to 10.3% apply above about $1.08 million), and New York City residents add up to 3.876%, so the combined top state and city rate for NYC residents is about 14.8%.
• New York has both a state pass-through entity tax and a separate New York City pass-through entity tax that partnerships and S corporations can elect.
• New York taxes nonresidents on income from work performed in the state, so commuting physicians from New Jersey or Connecticut still file New York returns.

Where the savings usually come from

For most Long Island physicians, federal planning drives the largest results: W-2 strategies such as 401(k)/403(b), 457(b) and the backdoor Roth; 1099 and locum planning; entity and cash balance plan design for practice owners; and real estate strategies for physicians with time to participate.

More physician tax guides

• Other New York cities: New York City, Yonkers, Buffalo, Rochester, Albany.
• State rules: New York physician tax guide and all 50 state guides.
• By specialty: Dentists, Ophthalmologists, Hospitalists, Radiologists and every specialty.
• Core strategy: tax planning for physicians, tax planning for medical practice owners, advanced strategies for high-income physicians and S corporation tax planning for physicians, plus the physician tax glossary.

This article is for general educational purposes and is not tax, legal or investment advice. Tax law changes often and its application depends on your facts. Figures reflect 2026 rules as published by the sources listed above. Consult a qualified professional before acting. See our editorial policy.