Surgeons Group Membership Application

Please read the rules and regulations, then sign and mail the required documents listed below:

  • Copy of your state registration to practice medicine (Office of Professions Registration Certificate with expiration date)
  • Passport size photo (for your picture ID)
  • Check or money order for $500 to NYSPIA Surgeons Group

Mail to: NYSPIA Surgeons Group – 421 Loudon Road, Albany, NY 12211

Questions? – email

You can apply to join the NYSPIA Surgeons Group by downloading the application below and submitting it to NYSPIA.

Surgeons Group Application