Inside Northwell’s Real Estate Expansion: How New York’s Largest Health System is Reshaping Long Island

Northwell Health may be best known for transforming lives through cutting-edge healthcare, but it has also been quietly transforming Long Island’s real estate landscape. From massive office redevelopments to neighborhood outpatient centers, the state’s largest health system has become one of the region’s most influential builders, buyers, and tenants.

From Office Towers to Medical Malls

One of Northwell’s boldest real estate plays came with the 1.4 million-square-foot property at 1111 Marcus Avenue in Lake Success. Once home to the United Nations and later Sperry Rand, the massive office complex is now a “medical mall” filled with clinical services, doctors’ offices, and administrative hubs.

Northwell’s real estate team was deliberate in reshaping the property. “The medical pieces of the building are located closer to the parking,” explained Thomas Nappi, Vice President of Real Estate Strategy and Finance. “That building was very much a non-clinical building. We continue to put clinical care in that building.”

Because the facility sits slab-on-grade, Northwell was able to install heavy medical equipment without expensive reinforcement. Every decision—down to patient flow and parking—was guided by the patient experience.

Breathing Life into Vacant Buildings

More recently, Northwell acquired a 300,000-square-foot office building at 200 Jericho Quadrangle. Once leased to Cablevision and Altice USA, the building had sat empty for two years. Northwell now plans to reimagine it for healthcare services that address the evolving needs of Long Islanders.

This is part of a larger pattern. Across the region, Northwell has been turning underutilized commercial and retail properties into thriving medical hubs. An old grocery store in Bay Shore was converted into a cancer center. Vacant big box stores, once symbols of retail decline, are now seen as opportunities for high-visibility healthcare sites.

A Network Beyond Hospitals

With 28 hospitals, 1,000+ outpatient facilities, and more than 100,000 employees, Northwell is already the state’s largest health system. But the future of healthcare is less about hospital stays and more about outpatient access.

“We’ve been very active in expanding our ambulatory network to feed hospitals,” said Nappi. “That’s where we see continued growth on Long Island.”

This shift mirrors a larger trend: imaging, same-day surgery, and specialty care are increasingly being provided outside of hospitals in purpose-built spaces. These facilities require precise real estate planning—reinforced floors for MRI machines, tall ceilings for surgical equipment, and ample parking for patients.

Expanding Eastward

Historically Nassau-focused, Northwell is now extending further into Suffolk County, investing in South Shore University Hospital and Peconic Bay Medical Center. With Long Island’s population aging, demand for care closer to home continues to grow, particularly in Suffolk where medical services are less dense.

“It feels to me like there’s more potential for growth in Suffolk,” Nappi said.

Balancing Costs and Community

Healthcare expansion doesn’t come cheap, especially on Long Island where real estate prices remain high. But as a nonprofit, Northwell often avoids direct property tax obligations when it purchases buildings—something Nappi says ultimately benefits patients.

Much of its construction is funded through philanthropy, though the system also partners with large construction managers and occasionally taps the Dormitory Authority of the State of New York for financing.

Beyond buildings, housing for employees remains a challenge. Recruiting top talent is easier said than done when affordable options are scarce. “We need more housing on Long Island,” Nappi noted.

Looking Ahead

Even as virtual care grows, healthcare remains deeply tied to physical spaces. Unlike many industries that downsized office footprints after Covid, healthcare continues to expand, often making use of empty commercial properties.

“Historically, the real estate market, education, and healthcare were more recession-proof than other niches,” Nappi observed. “We’ll continue to acquire new space.”

For Long Island, that means more hospitals, clinics, and specialty centers woven into communities—reshaping not only how people access healthcare, but also how real estate is used across the region.

FAQs: Northwell’s Real Estate Expansion

What is Northwell’s largest real estate project on Long Island?
The transformation of 1111 Marcus Avenue in Lake Success into a 1.4 million-square-foot medical campus is considered one of its biggest real estate redevelopments.

Why is Northwell buying vacant office buildings?
Repurposing existing structures, like the 200 Jericho Quadrangle, allows Northwell to expand quickly and cost-effectively while addressing Long Island’s healthcare needs.

How does Northwell’s expansion impact patients?
By creating more outpatient facilities and specialty centers, Northwell makes care more convenient and accessible, reducing the need for hospital visits for many procedures.

Why is Northwell focusing on Suffolk County?
Historically more concentrated in Nassau, Northwell sees Suffolk as an area with strong growth potential and increasing demand for local healthcare services.

Does Northwell pay property taxes on the buildings it buys?
As a nonprofit, Northwell typically does not pay property taxes on purchased properties, though landlords cover them when Northwell leases space.