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Subject Number 046-1036 Newly Authorized Health Care Providers Approved to Render Services to Injured Workers Under the Workers' Compensation Law

Subject Numbers Regarding Health Provider Authorizations

March 8, 2018

The following have been added to the list of providers authorized to treat injured workers and/or perform independent medical examinations within the New York State workers’ compensation system.

NAME SPECIALTY AREA OF PRACTICE CITY OF PRACTICE AUTHORIZATION NUMBER* EFFECTIVE DATE
Anca, Diana Anesthesiology New York 243958-6W February 15, 2018
Jensen, Mark Robert Anesthesiology Rochester 276356-3W February 6, 2018
Ricanor, Rainier Jude Anesthesiology, Pain Management Pelham 285337-2B February 5, 2018
Shoemaker, Mark Charles Anesthesiology Albany 225483-7B February 23, 2018
Straub, Benjamin Joseph Anesthesiology New Rochelle 276045-2W February 22, 2018
Cohen, Randy Edward Cardiovascular Middletown 239884-0W February 22, 2018
Bau, Jennifer Lynn Diagnostic Radiology Corning 285394-3W February 13, 2018
Lee, Cindy Diagnostic Radiology Garden City 286719-0B February 22, 2018
Lee, Susan Catherine Diagnostic Radiology New York 282850-7B February 23, 2018
Park, James Diagnostic Radiology New York 282661-8B February 22, 2018
Qiu, William Weiguang Diagnostic Radiology New York 228377-8W February 8, 2018
Ravi, Ananth Kumar Diagnostic Radiology Corning 284688-9W February 1, 2018
Campbell, Christina L. Emergency Medicine Johnson City 291037-0W February 1, 2018
Huynh, Quang Nhut Family Practice Bronx 290912-5W February 14, 2018
Mathews, Premila Maria Family Practice Mt Kisco 267709-4B February 14, 2018
Morcos, David Family Practice Monticello 289774-2W February 22, 2018
Ni, Kimberly Family Practice Vestal 290771-5W February 14, 2018
Peaden, Taylen Clay Family Practice Little Falls 291018-0W February 1, 2018
Taufik, Mireille Family Practice Corning 285213-5W February 14, 2018
Abidi, Mohammad Ali Internal Medicine Johnson City 291049-5W February 14, 2018
Churchill, Todd Thomas Internal Medicine Oneonta 234237-6W February 8, 2018
Kalil, Marissa Z. Internal Medicine New Hartford 244545-0W February 7, 2018
Parikh, Leslie Russell Internal Medicine, Cardiovascular Disease Rumford 288411-2I February 8, 2018
Raza, Khadija Internal Medicine Vestal 290153-6W February 6, 2018
Soussan, Louisette Lise Internal Medicine, Nephrology Cooperstown 287524-3W February 13, 2018
Insinga, Salvatore Anthony Neurological Surgery West Islip 201754-9W February 6, 2018
Wu, Yaojie Neurology Middletown 273658-5W February 14, 2018
Angelilli, Allison Ophthalmology Bethpage 237377-7B February 22, 2018
Hayes, Daniel Donald Ophthalmology Bethpage 245893-3B February 22, 2018
Weiner, Asher Ophthalmology Orchard Park 217420-9B February 22, 2018
Banwar, Nitin S. Orthopedic Surgery Clifton Springs 148060-7I February 15, 2018
Levitt, Richard L. Orthopedic Surgery Brooklyn 291679-9B February 12, 2018
Sutton, Karen Michelle Orthopedic Surgery New York 291091-7W February 5, 2018
Thompson, Willie Edward Orthopedic Surgery Brooklyn 288000-3B February 12, 2018
Wetzel, Franklin Todd Orthopedic Surgery Cooperstown 291444-8W February 1, 2018
Gore, Mitchell Ray Otolaryngology Liverpool 278482-5B February 22, 2018
Lee, Heather Eunjoo Otolaryngology Rochester 283340-8W February 22, 2018
Pizarro, Emerita A. Pediatrics New Hartford 205704-0W February 16, 2018
Avolio, Jock Alfred Physical Medicine/Rehabilitation Clifton 195153-2W February 12, 2018
Hattab, Raed Physical Medicine/Rehabilitation, Pain Management Rego Park 234546-0B February 22, 2018
Mattei-Gonzalez, Gabriel Physical Medicine/Rehabilitation Airmont 286142-5W February 15, 2018
Thiyagarajah, Aathirayen Physical Medicine/Rehabilitation, Pain Management Binghamton 288486-4W February 1, 2018
Arndt, David Henry Podiatry N Syracuse P06434-6W February 6, 2018
Benitez, Camilo Jose Podiatry Fresh Meadows P06791-9W February 6, 2018
Berlin, Lance R. Podiatry Islip P04704-4W February 6, 2018
Chi, Yu-Ching Podiatry New Hyde Park P06799-2B February 6, 2018
Ellie, Christine M. Podiatry New York P06402-3W February 6, 2018
Gogna, Anuj Podiatry Nesconset P06890-9B February 6, 2018
Han, Jungwoo Podiatry Pearl River P06740-6B February 6, 2018
Harris, Samantha Yvonne Podiatry Champlain P06901-4W February 6, 2018
Haskin-Cole, Crystal J. Podiatry Warwick P06574-9W February 6, 2018
Knowles, Allyssa Maria Podiatry Brooklyn P06720-8B February 6, 2018
Larocca, Alexandra Podiatry West Islip P06843-8W February 6, 2018
Nowak, Jessica Podiatry Williamsville P06847-9W February 6, 2018
Prevete, Jacqueline Lee Podiatry New Hyde Park P06846-1B February 6, 2018
Registre, Edner Franklin Podiatry Elmont P06837-0W February 6, 2018
Richards, Jonathan Jacob Podiatry New York P06522-8W February 6, 2018
Rosenfeld, Lonny Roy Podiatry Monticello P06723-2W February 6, 2018
Sabghir, Arianna Podiatry Brooklyn P06806-5W February 6, 2018
Shah, Nazia Podiatry Brooklyn P06801-6W February 6, 2018
Stewart, David John Podiatry Flushing P05255-6W February 6, 2018
Chaudhri, Mahipal Singh Psychiatry Rochester 196375-0B February 12, 2018
Bang, Charlene Psychology Jackson Heights S14777-7B February 9, 2018
Frank, Chiyoko Kobayashi Psychology Ithaca S21554-1W February 9, 2018
Gonzalez, Annette Psychology Elmhurst S20981-7B February 9, 2018
Livanos, Elisa Antoinette Psychology Rockville Centre S20922-1W February 9, 2018
Pierce, Pamela Jo Psychology Hauppauge S20113-7B February 9, 2018
Tolchin, Nicholas Imre Psychology Bayside S18227-9W February 9, 2018
Choi, Jennifer Jaehee Radiology – Diagnostic Radiology New Hyde Park 287898-1W February 15, 2018
Gaur, Sarel Radiology – Diagnostic Radiology Corning 288198-5W February 13, 2018
Mani, Kartik M. Radiology – Radiological Oncology Stony Brook 273671-8W February 5, 2018
Chawla, Ankur Surgery, General Vascular Surgery Utica 258725-1W February 2, 2018
Kalnoki-Kis, Emese Surgery Rochester 287964-1W February 13, 2018
Rojas, Ortiz Yoel Antonio Surgery Garden City 271900-3W February 15, 2018
Tamar, Kyron C. Surgery Lowville 132492-0W February 15, 2018
Larish, Yaniv Moshe Urology Glendale 281709-6W February 12, 2018

* 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.

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

Clarissa M. Rodriguez
Chair