Which New York Hospitals Have Level III and Level IV NICUs?

When a baby needs intensive medical care after birth, the level of NICU matters tremendously. Not all neonatal intensive care units can provide the same services. Some hospitals have the equipment and specialists to handle straightforward premature births, while others can perform complex surgeries and manage the most medically fragile newborns.

New York State runs one of the most organized systems in the country for making sure babies get to the right place. The state has 56 hospitals with NICU beds and 17 hospitals designated as Regional Perinatal Centers, which represent the highest level of newborn care available.

Understanding which hospitals offer what level of care can help families make informed decisions about where to deliver, especially when complications are anticipated or when a baby needs transfer to a higher level of care after birth.

Understanding the Four Levels of Neonatal Intensive Care

The American Academy of Pediatrics defines four distinct levels of neonatal care. Each level builds on the previous one, adding more specialized equipment, more expert staff, and the ability to handle more complex medical conditions.

Level I nurseries provide care for healthy newborns and can stabilize babies who develop problems until transfer.

Level II NICUs (also called Special Care Nurseries) care for babies born at 32 weeks or later who have problems that are expected to resolve quickly, and babies who are recovering from serious illness but no longer need intensive care.

Level III NICUs provide comprehensive care for extremely premature infants and critically ill newborns of any gestational age. Level IV NICUs (Regional Perinatal Centers in New York) provide the most advanced care, including complex surgery and the full range of pediatric subspecialists on site.

What Services Do Level III NICUs Provide?

Level III NICUs can care for babies born at any gestational age with complex medical conditions requiring life support. These units maintain:

• Board-certified neonatologists available at all times
• Specialized neonatal nurses and respiratory therapists around the clock
• Advanced breathing support including conventional ventilators, high-frequency ventilation, and inhaled nitric oxide therapy
• Quick access to pediatric medical specialists and surgeons (either on site or at closely affiliated hospitals)
• Advanced imaging with urgent interpretation, including CT scans, MRI, and echocardiograms
• Organized programs for monitoring and treating retinopathy of prematurity, an eye condition affecting very premature babies
• Capability to perform major surgeries with pediatric anesthesiologists

These units can manage babies with serious respiratory distress, extreme prematurity, complex heart conditions, neurological problems, and infections requiring intensive treatment.

What Makes Level IV NICUs Different From Level III?

Level IV NICUs, which New York calls Regional Perinatal Centers, provide everything a Level III NICU offers plus additional capabilities that set them apart:

• On-site surgical repair of serious birth defects and acquired conditions requiring complex operations
• Full range of pediatric medical subspecialists and pediatric surgeons physically located at the hospital, not just on call from elsewhere
• Extensive experience caring for the most medically complex and critically ill newborns
• Coordinated transport systems to bring sick babies from other hospitals
• Educational outreach and quality improvement support for other hospitals in their region

The practical difference is significant. If a baby needs neurosurgery, cardiac surgery, or repair of complex gastrointestinal malformations, a Level IV NICU can provide that care immediately without transferring the baby to another facility. These centers also tend to see higher volumes of the most challenging cases, which means their teams have more experience with rare and complex conditions.

New York State Volume Requirements for NICU Designation

New York doesn’t just look at what equipment a hospital has. The state requires hospitals to maintain minimum patient volumes to ensure their teams stay experienced and competent.

Level II Perinatal Centers must provide at least 1,200 high-risk newborn patient days annually and at least 150 high-risk maternal patient days annually.

Level III Perinatal Centers must provide at least 2,000 high-risk newborn patient days annually and at least 250 high-risk maternal patient days annually.

Regional Perinatal Centers (Level IV) must provide at least 4,000 high-risk newborn patient days annually and at least 400 high-risk maternal patient days annually. They must also provide quality improvement services to affiliated hospitals that collectively deliver at least 8,000 babies per year.

If a hospital falls below these minimum volumes, it must present evidence that it will meet the standards within one year. The Department of Health can waive volume requirements only if doing so improves access to care while maintaining quality.

The regulations also require that surface travel time to reach a Level II, III, or Regional Perinatal Center must be no more than two hours under normal conditions. Every Level I, II, and III hospital must have written affiliation agreements with a Regional Perinatal Center to coordinate transfers and share expertise.

Complete List of New York Hospitals With NICU Beds

According to New York State Health Profiles, 56 hospitals across the state maintain neonatal intensive care beds. The 17 Regional Perinatal Centers (Level IV) are also noted below, all with their corresponding ZIP Codes.

Manhattan NICU Hospitals

• Bellevue Hospital Center (10016) – Regional Perinatal Center
• Harlem Hospital Center (10037)
• Lenox Hill Hospital (10021)
• Metropolitan Hospital Center (10029)
• Mount Sinai Hospital (10029) – Regional Perinatal Center
• Mount Sinai West (10019)
• NewYork-Presbyterian David H. Koch Center (10065) – Regional Perinatal Center
• NewYork-Presbyterian Hospital Columbia (10032) – Regional Perinatal Center
• NYU Langone Hospitals (10016) – Regional Perinatal Center

Brooklyn NICU Hospitals

• Brookdale Hospital Medical Center (11212)
• Brooklyn Hospital Center Downtown Campus (11201)
• Kings County Hospital Center (11203)
• Maimonides Medical Center (11219) – Regional Perinatal Center
• New York-Presbyterian Brooklyn Methodist Hospital (11215)
• University Hospital of Brooklyn (11203) – Regional Perinatal Center
• Woodhull Medical & Mental Health Center (11206)
• Wyckoff Heights Medical Center (11237)

Queens NICU Hospitals

• Elmhurst Hospital Center (11373)
• Flushing Hospital Medical Center (11355)
• Jamaica Hospital Medical Center (11418)
• Long Island Jewish Medical Center (11040) – Regional Perinatal Center
• New York-Presbyterian Queens (11355)
• Queens Hospital Center (11432)

Bronx NICU Hospitals

• BronxCare Hospital Center (10457)
• Jacobi Medical Center (10461)
• Lincoln Medical & Mental Health Center (10451)
• Montefiore Medical Center Jack D Weiler Hospital (10461) – Regional Perinatal Center
• Montefiore Medical Center Wakefield Hospital (10466)
• North Central Bronx Hospital (10467)

Staten Island NICU Hospitals

• Richmond University Medical Center (10310)
• Staten Island University Hospital North (10305)

Nassau County NICU Hospitals

• Good Samaritan Hospital Medical Center (11795)
• Mercy Hospital (11570)
• Nassau University Medical Center (11554)
• North Shore University Hospital (11030) – Regional Perinatal Center
• NYU Langone Hospital Long Island (11501) – Regional Perinatal Center

Suffolk County NICU Hospital

• Stony Brook University Hospital (11794) – Regional Perinatal Center

Westchester County NICU Hospitals

• Northern Westchester Hospital (10549)
• Westchester Medical Center (10595) – Regional Perinatal Center
• White Plains Hospital Center (10601)

Buffalo Area NICU Hospitals (Erie County)

• John R. Oishei Children’s Hospital (14203) – Regional Perinatal Center
• Mercy Hospital of Buffalo (14220)
• Millard Fillmore Suburban Hospital (14221)
• Sisters of Charity Hospital (14214)

Rochester Area NICU Hospitals (Monroe County)

• Rochester General Hospital (14621)
• Strong Memorial Hospital (14642) – Regional Perinatal Center

Syracuse Area NICU Hospitals (Onondaga County)

• Crouse Hospital (13210) – Regional Perinatal Center
• St. Joseph’s Hospital Health Center (13203)

Albany Area NICU Hospitals (Albany County)

• Albany Medical Center Hospital (12208) – Regional Perinatal Center
• St. Peter’s Hospital (12208)

Other Upstate New York NICU Hospitals

• Arnot Ogden Medical Center, Chemung County (14905)
• Cayuga Medical Center at Ithaca, Tompkins County (14850)
• Garnet Health Medical Center, Orange County (10940)
• Samaritan Medical Center, Jefferson County (13601)
• United Health Services Hospitals Wilson, Broome County (13790)
• Vassar Brothers Medical Center, Dutchess County (12601)

Details About New York’s Level IV Regional Perinatal Centers

Mount Sinai Kravis Children’s Hospital

Mount Sinai operates a 46-bed Level IV Regional Perinatal Center that cares for approximately 1,000 newborns annually. The unit specializes in multi-organ system problems, complex congenital heart disease, chronic lung disease, organ transplant consultations, and rare metabolic disorders. Mount Sinai West operates a separate 35-bed Level III NICU at a different location.

NewYork-Presbyterian Alexandra Cohen Hospital

The David H. Koch Center houses a 60-bed Level IV NICU that opened in 2020. It was the first NICU in New York City with a dedicated MRI machine and operating room located inside the unit itself, eliminating the need to transport critically ill babies through the hospital for imaging or surgery. The facility accommodates births from over 7,000 deliveries annually. NewYork-Presbyterian Morgan Stanley Children’s Hospital operates an additional Level IV NICU with Regional Perinatal Center designation at the Columbia campus.

NYU Langone Health

NYU Langone Hospitals at Tisch Hospital operates a Level IV NICU with Regional Perinatal Center designation. Bellevue Hospital, which is affiliated with NYU, also operates a Level IV NICU with Regional Perinatal Center designation. NYU Langone Hospital Brooklyn operates a Level II NICU.

Maimonides Medical Center

This Brooklyn hospital recently expanded its Level IV NICU to 48 beds. The facility provides 24/7 neonatologist coverage and tied for first place nationally in 2022 for helping patients avoid inappropriate elective deliveries before 39 weeks, when babies’ organs may not be fully developed.

Strong Memorial Hospital

Located in Rochester, Strong serves as the designated Regional Perinatal Center for the Finger Lakes Region. The Level IV program provides surgical repair of complex birth defects, maintains full pediatric subspecialty and surgical staff on site, and coordinates transport and educational outreach throughout the region.

NYU Langone Hospital Long Island

This facility operates a Level III NICU (by AAP definition) and holds Regional Perinatal Center designation from New York State. The hospital delivers over 5,000 babies annually and earned Advanced Perinatal Center of Excellence designation from The Joint Commission, recognizing quality and safety standards.

John R. Oishei Children’s Hospital

Buffalo’s Regional Perinatal Center provides the highest level of neonatal care for Western New York.

Other Regional Perinatal Centers

The remaining Regional Perinatal Centers serve their geographic regions: Long Island Jewish Medical Center and North Shore University Hospital in Nassau County; University Hospital of Brooklyn (SUNY Downstate); Stony Brook University Hospital in Suffolk County; Westchester Medical Center; Montefiore Medical Center in the Bronx; Albany Medical Center; and Crouse Hospital in Syracuse.

National Context for NICU Levels and Bed Capacity

Understanding New York’s system helps to know how it compares nationally. The United States has 1,424 operational NICUs with a total of 35,601 beds:

• 570 Level II NICUs (40% of units) with 5,592 beds
• 702 Level III NICUs (49% of units) with 20,631 beds
• 152 Level IV NICUs (11% of units) with 9,378 beds

Level IV NICUs average 55 beds with a typical range of 42 to 72 beds. Level III NICUs average 25 beds with a typical range of 16 to 37 beds. The size difference reflects the broader catchment areas that Level IV centers serve and their role as referral centers for multiple hospitals.

Survival Rates for Extremely Premature Babies

When a baby is born extremely premature (before 29 weeks), outcomes depend heavily on gestational age at birth and the quality of care received. Recent data from 19 academic medical centers across the United States shows that 78.3% of extremely preterm infants born between 2013 and 2018 survived to discharge, an improvement from 76% in 2008-2012.

Survival rates increase dramatically with each additional week in the womb:

• 22 weeks: 11% overall survival (30% among babies who receive active resuscitation)
• 23 weeks: 55% survival
• 28 weeks: 94% survival

California data following resuscitated infants shows survival to discharge ranging from 33.2% at 22 weeks to 96.1% at 28 weeks. Importantly, survival without major complications also improved over time, particularly for babies born at 28 weeks.

Globally, outcomes vary significantly based on country income level. In high-income countries like the United States, 69.3% of extremely preterm infants survive, compared to just 44.3% in low and middle-income countries. Among survivors, 51.7% are discharged without major complications worldwide.

These statistics explain why Regional Perinatal Centers exist and why volume requirements matter. Experience with the most premature and critically ill babies translates directly into better survival and better long-term outcomes.

Infant Mortality Statistics in New York State

New York’s infant mortality rate was 4.3 per 1,000 live births in 2023, with 478 infant deaths that year. This represents ongoing improvement from 4.5 per 1,000 in 2016.

Breaking down the data shows where babies are most vulnerable. Neonatal mortality (deaths in the first 28 days) accounted for 3.0 per 1,000 live births, while post-neonatal mortality (deaths between 29 days and one year) accounted for 1.5 per 1,000.

Significant disparities persist by race and ethnicity. From 2008 to 2016:

• Non-Hispanic White infant mortality declined 9% to 3.45 per 1,000
• Non-Hispanic Black infant mortality declined 28% but remained more than twice as high at 7.85 per 1,000
• Hispanic infant mortality declined 3% to 3.6 per 1,000
• Non-Hispanic Asian and Pacific Islander populations had the lowest rate at 2.87 per 1,000

New York City specifically had an infant mortality rate of 4.0 per 1,000 live births in 2021, up slightly from 3.9 in 2020.

The leading causes of infant death in New York are prematurity, birth defects, and sudden unexpected infant death. Notably, early term babies born at 37 to 38 weeks experience nearly twice the mortality rate of full-term babies born at 39 to 40 weeks (2.32 versus 1.31 per 1,000 live births), which is why hospitals now avoid elective deliveries before 39 weeks.

Prematurity and Low Birthweight Rates in New York

Approximately 9.6% of births in New York in 2023 were preterm (born before 37 weeks), representing 1 in every 10 babies. About 8.6% of births were low birthweight (less than 2,500 grams or 5.5 pounds).

Nationally, NICU admission rates have increased across all gestational age and birthweight categories from 2016 to 2023. Among preterm infants specifically, NICU admission rates increased 5%, from 49.1% to 51.6%. Preterm and low birthweight infants are at least seven times more likely to need NICU care than babies born at later gestational ages and higher birthweights.

This trend explains the continued need for specialized neonatal care facilities and underscores the importance of the tiered system New York has established.

Maternal Fetal Medicine Services at Regional Perinatal Centers

All 17 Regional Perinatal Centers provide maternal-fetal medicine subspecialty services. These programs care for high-risk pregnancies and can diagnose and sometimes treat conditions before birth.

NewYork-Presbyterian Columbia University Irving Medical Center

The Carmen and John Thain Center for Prenatal Pediatrics offers multidisciplinary care for pregnancies complicated by fetal malformations, genetic syndromes, or multiple gestations. The program performs advanced procedures including fetoscopy, laser photocoagulation for twin-twin transfusion syndrome, fetal blood sampling, and radiofrequency ablation for certain conditions.

NYU Langone Health

NYU operates the only fetal surgery program on Long Island and provides maternal-fetal medicine services across Manhattan, Brooklyn, and Long Island. Services include chorionic villus sampling, detailed nuchal translucency screening, umbilical cord blood sampling, blood transfusions for fetal anemia, and fetoscopic laser photocoagulation for twin complications.

Mount Sinai Health System

Mount Sinai offers maternal-fetal medicine expertise across multiple locations with subspecialists in diabetes care during pregnancy, obstetric ultrasound, and clinical informatics.

These programs can make a critical difference when problems are detected during pregnancy. Early diagnosis allows for delivery planning at the appropriate level hospital, coordination with pediatric specialists who can be present at birth, and sometimes prenatal interventions that improve outcomes.

How New York Tracks and Improves Newborn Outcomes

New York maintains a comprehensive Statewide Perinatal Data System that requires all hospitals and birthing centers to report detailed information. The system collects birth certificate data, supplemental information about high-risk pregnancies, and detailed NICU data for every baby who spends more than four hours in special care or intensive care.

This data infrastructure supports public health surveillance, allows hospitals to compare their outcomes and identify areas for improvement, and enables researchers to study what factors lead to better outcomes. The system is part of what makes New York’s perinatal regionalization effective. Problems can be identified and addressed systematically rather than hospital by hospital.

What This Means for Families

The difference between NICU levels is not about better or worse hospitals. Level II NICUs provide excellent care for the conditions they are designed to handle. But when a baby needs complex surgery, treatment for rare metabolic conditions, or management of extreme prematurity, a Level IV Regional Perinatal Center has resources and experience that other facilities simply cannot match.

New York’s system is designed to match babies with the right level of care. When complications are known before birth, delivery can be planned at an appropriate facility. When problems arise unexpectedly, the affiliation agreements and transport systems are designed to move babies quickly to where they need to be.

For families facing a high-risk pregnancy or unexpected complications, knowing which hospitals provide which level of care can inform conversations with medical providers about the best place for delivery or transfer. The 17 Regional Perinatal Centers across New York ensure that no family is more than two hours from the highest level of care, even in a large and geographically diverse state.