Do NPs need a supervising physician in New York?

Whether NPs need a supervising physician in New York depends on experience. NPs with fewer than 3,600 practice hours must collaborate with a physician under a written practice agreement and written practice protocols¹. Once an NP has more than 3,600 hours, formal practice agreements are not required, but the NP must maintain collaborative relationships with qualified physicians or a hospital and complete the Department’s attestation form².

For NPs who require a collaborating physician, the agreement and protocols must address dispute resolution, timely (at least quarterly) patient record review, referrals and consultations, and coverage for absences, and protocols must reflect accepted standards of nursing and medical practice³. Additionally, a physician may not enter into written practice agreements with more than four NPs who are not located on the same physical premises as the physician⁴.

For NPs in independent practice (3,600+ hours), the required collaborative relationships include ongoing communication with qualified physicians or a hospital, completion and maintenance of the Department’s attestation form, acknowledgement that unresolved care disputes defer to the physician’s recommendation, and documentation supporting the relationship; failure to comply constitutes professional misconduct².