Orthopedic Doctor Accepting NYSHIP and the Empire Plan

If you’re a New York State employee, a retiree, or covered through a participating public employer, you already know the drill: you find a doctor, then you spend twenty minutes trying to work out what your plan actually covers.

Mirza Orthopedics accepts NYSHIP and the Empire Plan at both our Smithtown and Bellmore offices. We treat hand, wrist, elbow, shoulder, and knee conditions, and we work with public employees and their families across Long Island every week.

This page covers what you need to know before you book — including one Empire Plan rule about physical therapy that catches a lot of people off guard.

NYSHIP vs. the Empire Plan: What’s the Difference?

This trips up a lot of people, and it’s worth thirty seconds.

NYSHIP — the New York State Health Insurance Program — is the program itself. It covers state employees, retirees, and their dependents, along with employees of participating agencies and participating employers like many school districts and municipalities.

The Empire Plan is the primary plan option offered through NYSHIP, and it’s what most NYSHIP enrollees have. It’s a PPO. NYSHIP also offers HMO options in some areas.

So when someone says “I have NYSHIP,” they usually mean they have the Empire Plan. When you call our office, telling us which one you have helps us verify your benefits faster.

The Empire Plan is administered in parts, which is why you may have been handed several different phone numbers:

Medical and surgical care — including office visits and surgery — is administered by UnitedHealthcare.
Anthem Blue Cross administers hospital coverage.
Physical therapy, occupational therapy, and chiropractic care run through the Managed Physical Medicine Program, administered with Managed Physical Network (MPN)

You Don’t Need a Referral

The 2026 Empire Plan Summary of Benefits and Coverage answers this plainly: no referral is required to see a specialist, and you can see the specialist you choose without permission from the plan.

If you have shoulder pain, a wrist injury, or a knee that’s been getting worse, you can call us directly. You don’t need to route through a primary care physician first.

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Specialties We Treat

Elbow

Shoulder

Wrist

Hand

Knee

If you are unsure whether your condition is covered by NYSHIP / The Empire Plan, our staff can help review your insurance information before your appointment.

Why Public Employees Choose Mirza Orthopedics

We treat many people who work for the public

Dr. Justin Mirza serves as a police surgeon with the Police Surgeons Benevolent Association of New York, and our practice cares for first responders and public servants across Long Island. If your job is physical, we understand what “cleared to return to work” actually has to mean.

Fellowship-trained subspecialty care

Dr. Justin Mirza completed fellowship training in Hand and Upper Extremity Surgery at Stony Brook University Hospital, where he also serves as a Clinical Professor and Level 1 trauma surgeon.

Surgery isn’t the default.

Many conditions we see improve without an operation — through injections, bracing, activity modification, or therapy. When surgery is the right answer, we explain why and what recovery involves before you decide.

We’re involved in the community we serve.

Dr. Mirza serves as a team physician for Nassau and Suffolk County high school football and the county wrestling championships.

Two surgeons wearing scrubs, masks, and gloves perform a surgical procedure under bright lights. “Mirza Orthopedics” is visible in the lower right corner.

Our Office Locations

Smithtown:

Suffolk County 290 East Main Street, Suite 200, Smithtown, NY 11787 (631) 361-5302

Bellmore:

Nassau County 2307 Bellmore Ave, Bellmore, NY 11710 (516) 973-5266

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Frequently Asked Questions for an Orthopedic Doctor that Accepts NYSHIP Insurance

Do you accept NYSHIP?

Yes. NYSHIP and the Empire Plan are among the insurance plans we accept at both our Smithtown and Bellmore offices. Call us with your card, and we’ll help verify your specific benefits.

Is NYSHIP the same thing as the Empire Plan?

Not quite. NYSHIP is the New York State Health Insurance Program. The Empire Plan is the primary plan option offered through NYSHIP, and it’s what most enrollees have. NYSHIP also offers HMO options in some areas.

Do I need a referral to see an orthopedist with the Empire Plan?

No. The 2026 Empire Plan documents state that no referral is required to see a specialist.

Do I need approval before an MRI?

Yes. The Empire Plan requires precertification for MRI, CT, and PET scans that aren’t emergencies or part of an inpatient procedure. Without it, your cost will be higher.

I'm retired, and Medicare is now primary. Does that change things?

Yes, coverage coordinates differently once Medicare is primary, and some benefits are affected. Call 1-877-7-NYSHIP or check your plan documents, and let our office know when you schedule so we can verify correctly.

I'm covered through my school district, not the state. Does this apply to me?

Often, yes — many school districts and municipalities offer NYSHIP as participating employers. Benefits can differ from the state plan, so it’s worth verifying your specific group’s coverage.

Can I switch to your practice if I'm already being treated elsewhere?

Yes. Changing orthopedic providers mid-treatment is more routine than most patients assume. Bring your imaging and records, and we’ll pick up from where you are.

Hear From Our Patients

Patient Reviews

    
 
 
       Posted on Google  
   
   Rey Nunez 
 
 
 
 Trustindex verifies that the original source of the review is Google. I went. In for  shoulder surgery never had surgery before these people are angels. I love you, Dr.Mirza what a great job from you and your team,I will definitely recommend friends families.
  
 
      Posted on Google  
   
   Pete Muscara 
 
 
 
 Trustindex verifies that the original source of the review is Google. Great staff and Xcellent care , true professional
  
 
      Posted on Google  
   
   Thomas D'Agostino 
 
 
 
 Trustindex verifies that the original source of the review is Google. My experience with Doctor Mirza and his staff has been awesome !  Dr. Mirza is patient, answers a lot of questions and explains everything thoroughly including the PAs who assist him. The staff upfront are very nice, patient and helpful.
  
 
      Posted on Google  
   
   Jeanie Valenzuela 
 
 
 
 Trustindex verifies that the original source of the review is Google. Check in was smooth and fast. Front desk people were very nice and helpful.
  
 
      Posted on Google  
   
   Chavon Fredericks 
 
 
 
 Trustindex verifies that the original source of the review is Google. Great