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Subject Number 046-1070 Changes to the List of Health Care Providers Authorized to Render Services to Injured Workers Under the Workers' Compensation Law

Subject Numbers Regarding Health Provider Authorizations

June 4, 2018

Pursuant to Workers’ Compensation Law § 13-b, a provider must be licensed and registered with the New York State Education Department in order 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
Asaad, Bassem Onsy Saint Louis 256799-8W April 10, 2018
Aguero, Jose A. Lynbrook 135489-3W April 10, 2018
Bancroft, George Reid Hamburg 265999-3W April 10, 2018
Bazaz, Bansi Lal Ogdensburg 108852-5W April 10, 2018
Beil, Arthur Randall Port Washington 085095-8W April 10, 2018
Bekerus, Zorka Johnstown 107636-3W April 10, 2018
Beligotti, Ronald J. Watkins Glen C01927-5W April 10, 2018
Bell, Bertrand Monroe New York 078165-8W April 10, 2018
Bortolussi, Mario E. Marco Island 131003-6W April 10, 2018
Brouxhon, Sabine Lexington 220288-5W April 10, 2018
Capriotti, Philip E. Orono 156992-0W April 10, 2018
Cheda, Jesus New York 091170-1W April 10, 2018
Cole, Craig Neal Melbourne 259340-8W April 10, 2018
Danziger, Allan Cliffside Park 143865-4W April 10, 2018
Desai, Milind Pradip Bel Air 247936-8W April 10, 2018
Detullio, Daniel James Wappingers Falls C12174-1W April 10, 2018
Dinoff, Arthur New York 086117-9W April 10, 2018
Doane, Peter A. Auburn 128386-0W April 10, 2018
Egner, John George West Islip 080692-7W April 10, 2018
Evans, James Thomas Bluffton 105969-0W April 10, 2018
Farruggio, Paul P. Port Orange C11687-3W April 10, 2018
Fey, John Douglas Fayetteville 141280-8W April 10, 2018
Fischman, Alan S. Hopewell Junction 131761-9W April 10, 2018
Fix, Jeffrey Frederick Hamburg C08782-7B April 10, 2018
Fung, Tat Shing Amherst 219492-6W April 10, 2018
Ganem, Meyer M. Scarsdale 097480-8W April 10, 2018
Gardner, Sheila Fulton Charlotte 216989-4W April 10, 2018
Giantinoto, Anthony Deer Park C08691-0W April 10, 2018
Giometti, Renee Marie Garnet Valley 203670-5W April 10, 2018
Godesky, Mary T. Red Hook 099215-6B April 10, 2018
Grodberg, Jennifer Beth Brooklyn 219831-5W April 10, 2018
Gvardijan, Michael George Patchogue 080989-7W April 10, 2018
Hassan, Mahmoud Abdalla Ahmed Buffalo 277111-1W April 10, 2018
Ho, Andrew Tat-Chuen Utica 172375-8W April 10, 2018
Hochberg, Lisa K. Brooklyn 155438-5W April 10, 2018
Joven, Pedro Galang Lancaster 104946-9W April 10, 2018
Kass, Dan M. Southport 164677-7W April 10, 2018
Kleynerman, Iosif Brooklyn 173554-7W April 10, 2018
Koutelos, Thomas N. Brooklyn 190521-5W April 10, 2018
Lee, Eric New York 264765-9B April 10, 2018
Luzuriaga, Admirado Adolfo F., Jr. Apo 217493-6W April 10, 2018
Malfetano, John H. Guilderland 154115-0W April 10, 2018
Maurello, John M. Oceanside C04474-5B April 10, 2018
Mazur, Michael Thomas Syracuse 180257-8W April 10, 2018
McNeil, Connie Kaye Yonkers S14435-2W April 10, 2018
Monroe, Craig Andrew Binghamton 197303-1W April 10, 2018
Morris, Lori Ann New Paltz C05033-8W April 10, 2018
Moshides, Steven John East Aurora 164074-7W April 10, 2018
Newman, Elizabeth R. Hinesburg 283744-1W April 10, 2018
Ng, Jennifer New York 185299-5W April 10, 2018
Nostrame, Susan Anne Syracuse 177043-7W April 10, 2018
Ovanezian, George Scarsdale 100023-1W April 10, 2018
Palmer, Glenn Michael Skaneateles 217078-5W April 10, 2018
Pandya, Mahendra K. Staten Island 110002-3W April 10, 2018
Parikh, Suryakant East Islip 115321-2B April 10, 2018
Petkov, Theodore Michael Johnson City 165516-6W April 10, 2018
Phelps, Paul Owen Slingerlands 276931-3W April 10, 2018
Ramirez, Alain Miami Beach 251828-0B April 10, 2018
Ramirez-Racelis, Carmela New York 155020-1W April 10, 2018
Recitas, Teofilo P. Port Washington 126655-0W April 10, 2018
Robinson, Peter S. Jamestown 119678-1W April 10, 2018
Russo, Dennis West Baylon 154642-3B April 10, 2018
Sampson, Michael Grant Stony Brook 146289-4B April 10, 2018
Schecter, Arnold J. Louisville 115690-W April 10, 2018
Sehgal, Gautam Livingston 140763-4W April 10, 2018
Senal, Eugene Ira Mount Kisco 091734-4W April 10, 2018
Shah, Pankajlal S. Almond 145174-9W April 10, 2018
Silvers, Fred Great Neck 083203-0B April 10, 2018
Sollecito, Peter William New Burgh C05200-3W April 10, 2018
Sopchak, Andrew Michael Syracuse 181054-8W April 10, 2018
Stratemeier, Michael William Stony Brook 219353-0W April 10, 2018
Zackman, Myron Kent Hartsdale 108331-0W April 10, 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.

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