Bookkeeping for Upper East Side Medical & Dental Practices

# Bookkeeping for Upper East Side Medical & Dental Practices The Upper East Side has the highest density of independent physicians and dentists in the United States. Between Lenox Hill, Carnegie Hill, and Yorkville, more than **3,000 solo and small-group practices** operate north of 59th Street and east of Fifth Avenue. The bookkeeping problems are very specific. ## Why generic bookkeepers fail medical practices - They don''t know **Dentrix, eaglesoft, eClinicalWorks, Athena, DrChrono, or Kareo** and can''t reconcile against superbills. - They don''t flag **Section 179** in time to buy equipment before December 31. - They don''t handle the **NYC UBT** waiver for licensed professional services correctly. - They don''t structure **physician S-corps** for reasonable-compensation planning. ## Key tax wins for UES medical practices ### 1. Section 179 + bonus depreciation on equipment A $50K dental chair, a $35K ultrasound, a $15K laser — fully deductible in year of purchase up to **$1.16 million**. Bonus depreciation drops to 60% in 2024 and 40% in 2025, so 179 is the better path for most practices. ### 2. NYC UBT — the **professional services exemption** at issue Solo licensed professionals (MDs, DDS, DPM, DC, PT, OT) operating as a sole proprietor or single-member LLC owe NYC UBT at 4% on net income. There is **no general professional exemption** like NJ has — but there are deductions and credits (UBT credit on NYS tax, Form IT-219) we make sure you take. ### 3. S-corp election to cut self-employment tax A solo MD or DDS earning $400K+ usually saves **$10K–$25K/year** by electing S-corp status — paying themselves a reasonable W-2 salary (often $200K–$275K depending on specialty) and taking the rest as distributions exempt from FICA. ### 4. Retirement plan stacking - **Solo 401(k)** — $69K combined employee+employer contribution (2024). - **Defined benefit / cash balance plan** — often $150K+/year additional for owners over 50. - We coordinate with your TPA. ### 5. Practice loan interest, lease interest, malpractice insurance All deductible. We make sure they''re categorized correctly so your practice value (for future sale) shows true earnings. ## What our medical practice bookkeeping includes - Monthly reconciliation of operating, payroll, and savings accounts. - Reconciliation against PMS deposits (Dentrix, eClin, Athena, etc.). - Payroll for hygienists, assistants, front desk, associates (NYS-45, federal 941). - Quarterly NYC UBT and federal estimates. - Year-end S-corp 1120-S, partnership 1065, or 1040 Schedule C prep. - Section 179 / depreciation planning every November. - Profit & Loss with industry benchmarks (collections per chair, overhead %). ## Pricing Solo medical/dental practice: **$595–$1,200/month** including payroll for up to 8 staff. Multi-doctor practices: **$1,500–$3,000/month**. [Schedule a free UES medical practice consultation →](/contact)