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Subject Number 046-1381 January 2021 Changes to the List of Authorized Health Care Providers

Subject Numbers Regarding Health Provider Authorizations

March 8, 2021

Pursuant to Workers' Compensation Law § 13-b, a provider must be licensed and registered with the New York State Education Department to maintain a Workers' Compensation Board authorization(s).

The following have been removed from the list of providers authorized to treat injured workers and/or perform independent medical examinations within the New York State workers' compensation system based on information provided by the New York State Education Department indicating that they do not currently have an active license to practice medicine in New York State.

Name Last Known City of Practice Authorization Number* Effective Date
Abraham, Valsa Syosset 146184-7W January 13, 2021
Allyn, William Scott Elbridge 192213-7W January 13, 2021
Barnett, Lorna L. Brooklyn C06656-5W January 13, 2021
Berridge, Pattilee Uniondale C01967-1B January 13, 2021
Birnbaum, Jay William New York 148693-5W January 13, 2021
Breckenridge, Matthew L. Melville 269524-5W January 13, 2021
Brook, David William New York 088041-9W January 13, 2021
Brown, Anthony Reuben New York 174565-2W January 13, 2021
Marino, Nancy Ann Canandaigua 198581-1W January 13, 2021
Anderson, Sarah Marie Chatham C11331-8W January 13, 2021
Crawford, Joel Matthias Roseville 287637-3W January 13, 2021
D'Ascanio, Alfredo Amwalk 172634-9W January 13, 2021
Dorfman, Robert Press Newburgh 207181-9W January 13, 2021
Elsen, Stephanie M. Parkland 175064-5W January 13, 2021
Enriquez, Eduardo Manhasset 151563-4W January 13, 2021
Ferreira, De Sousa Romario Troy PT038837-1W January 13, 2021
Fields, Joel H. Larchmont 081881-5W January 13, 2021
Goe, Eric Albert Little Rock 183647-7B January 13, 2021
Green, Joan Marie Penn Yan OT003764-8W January 13, 2021
Gupta, Jessica Webster 289944-1W January 13, 2021
Herrera, Clarita E. Ridgewood 100699-8W January 13, 2021
Holt, Peter R. New York 082140-5W January 13, 2021
Huang, Zhaoming Manhasset 227290-4W January 13, 2021
Jean, Jong Chu Old Field 128588-1W January 13, 2021
Kaminski, Anna Katarzyna Rochester 262788-3W January 13, 2021
Knowles, Terry Canton 253764-5W January 13, 2021
Langer, Ruth New York 097407-1W January 13, 2021
Lee, Michael Sunghoon Smithtown 177160-9W January 13, 2021
Lin, Gracie Min-Mei Williamsville 184536-1B January 13, 2021
Lovallo, Sean Fayetteville PA015389-0 January 13, 2021
Luna-Rudin, Francesca Rosita Middletown 265282-4W January 13, 2021
Mandel, Donald Myron Westbury 094638-4W January 13, 2021
Marshall, Robert A. Westport C00892-2W January 13, 2021
Michaels, James Jay Fort Lauderdale C11754-1W January 13, 2021
Mihu, Nurkia Angelina Woodside 259639-3W January 13, 2021
Mobed, Darayes S. Clewiston 125186-7W January 13, 2021
Nagengast, Samantha Haley Freehold 260786-9W January 13, 2021
Nercessian, Ohannes Agop New York 153060-9W January 13, 2021
Petro, George Randall Johnson City 154359-4W January 13, 2021
Phillies, Gregory Paul Williamsville 138862-8W January 13, 2021
Piraino, David William Brecksville 222124-0B January 13, 2021
Polony, Andrew Beachwood 169655-8W January 13, 2021
Powers, John Cray Belle Harbor 091860-7W January 13, 2021
Raizon, Arnold Potomac 297157-0B January 13, 2021
Record, Duane C. Plattsburgh 127136-0W January 13, 2021
Rizzo, Robert John, Jr. Farmingville C09781-8B January 13, 2021
Ruggiero, George Richard Punta Gorda 216402-8B January 13, 2021
Salcedo, German Great River 093334-1W January 13, 2021
Schaller, Jonathan David Hamilton C08682-9W January 13, 2021
Schiavello, Henry Joseph Georgetown 089420-4W January 13, 2021
Segen, Joseph C. Manhasset 159746-7W January 13, 2021
Sharpton, Keith Thomas Corning 288887-3W January 13, 2021
Skolnik, Ezra Brooklyn 142612-1W January 13, 2021
Sutro, William H. Boynton Beach 134828-3W January 13, 2021
Szabo, Andras Hot Spring 228299-4W January 13, 2021
Tandoc, Merle N. West Seneca 139368-5W January 13, 2021
Thompson, Randall West Seneca C13013-0W January 13, 2021
Passidomo, Patrice Thornton Manchester Center 175691-5W January 13, 2021
Vacek, James John Johnstown 138653-1W January 13, 2021
Van Caneghem, Adrian New York 081686-8W January 13, 2021
Wani, Lubna Bashir Roanoke 263236-2W January 13, 2021
Welles, Richard V. Rochester 199166-0B January 13, 2021
Wolpert, Arthur Lantana 090515-8W January 13, 2021
Zhang, Jenny Stony Brook 289218-0W January 13, 2021

*Providers authorized to treat and perform independent medical examinations have an authorization number ending in B. Providers authorized to only treat have an authorization number ending in W. Providers authorized to only perform independent medical examinations have an authorization number ending in I.

These providers are prohibited from rendering treatment and care to injured workers and/or from performing independent medical examinations. Reports submitted for services rendered prior to the effective date are valid but are invalid for any services rendered on or after that date. Requests to cross-examine any of the above for services rendered prior to the effective date should not be denied due to the removal of their authorizations.

Any questions regarding the authorized lists should be referred to the Medical Director’s Office at 1 (800) 781-2362.

Clarissa M. Rodriguez
Chair