W-2, 1099, and K-1 at the same time
Most attending physicians have at least two income streams: a hospital or group W-2 and locum or moonlighting 1099 work. Many have partnership K-1s from practice ownership on top. Coordinating the three is most of the work.
Locum tenens and travel assignments
Locum work is almost always 1099, often across state lines. Each state where you practice can tax the income earned there, which means non-resident returns stacked on top of the home-state filing. Travel, lodging, licensing in additional states, and credentialing fees are deductible against locum income while your tax home stays put. When an assignment runs long enough that the work location becomes the tax home, the travel deductions stop, so assignment length is a planning decision, not just a scheduling one.
Practice ownership and structure
Medical practices are Specified Service Trades or Businesses (SSTBs) under Section 199A, which means the 20% QBI deduction phases out at higher incomes. Structuring owner compensation, retirement plans, and family employment matters more than it would in a non-SSTB.
- S-corp vs. PLLC analysis
- Cash balance plan combined with 401(k) for high-income partners
- Retirement plan design for both partners and staff
- QBI phase-out modeling
Residents, fellows, and the first attending year
Moonlighting during training is Schedule C income alongside the residency W-2, and it usually justifies a Solo 401(k) that shelters part of it. The jump to attending pay midyear creates a lopsided withholding picture and often the first brush with phase-outs: student loan interest, Roth IRA contribution limits, the QBI phase-out on 1099 work. The first attending year is the one to get in front of.
Physician-specific deductions
CME, board certification fees, required licensing, malpractice insurance (if not reimbursed), and job-search costs for a first-attending position all belong on the return.
Common questions
- Can I deduct my medical school loans?
- The principal is not deductible. Interest is deductible up to $2,500 if your income is below the phase-out. PSLF applies for nonprofit employers.
- What's the best retirement plan for a practice partner?
- Depends on income, partner count, and employee count. High-income solo or small-group practices often benefit from a cash balance plan combined with a 401(k).
- Do I need an LLC or PLLC for 1099 moonlighting?
- Not for tax reasons at modest income; Schedule C works fine. Liability and credentialing considerations sometimes justify a PLLC, and at higher 1099 income an S-corp election can save payroll tax. We model it before you commit.
- How do quarterly estimates work with mixed W-2 and 1099 income?
- We usually raise your W-2 withholding to cover the 1099 tax instead of running separate estimates. Withholding is treated as paid evenly through the year, which makes it the cleaner tool.
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Personal Income Tax Preparation
Federal and state 1040 preparation with year-round planning. We handle W-2, 1099, K-1, rental, and crypto income for individuals in Florida and all 50 states.
Tax Planning
Year-round tax planning for individuals and business owners. We project the year's income quarterly and model decisions before they become tax liabilities.
Corporation & Partnership Tax Returns
Forms 1120, 1120-S, and 1065 preparation for corporations, S-corps, and partnerships, plus owner K-1s, shareholder basis tracking, and multi-state filings.
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1099 commission income, mileage, home office, marketing expenses, quarterly estimates, and S-corp election analysis for real estate agents and brokers.
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