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Subject Number 046-1177 Newly Authorized Health Care Providers Approved to Render Services to Injured Workers Under the Workers' Compensation Law

Subject Numbers Regarding Health Provider Authorizations

June 12, 2019

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
Carinci, Adam John Anesthesiology, Pain Management Rochester 291417-4B May 15, 2019
Hernandez, Justin Anesthesiology Putnam Valley 294840-4W May 24, 2019
Mata, Joel Eduardo Anesthesiology, Pain Management Central Islip 280622-2W May 24, 2019
Myint, Soe Anesthesiology Brooklyn 225533-9W May 28, 2019
Rothstein, Daniel Anesthesiology, Pain Management New York 274814-3B May 24, 2019
Semanczuk, William Paul Anesthesiology Mount Kisco 220473-3W May 28, 2019
Starr, Don Michael Anesthesiology Rye Brook 185784-6W May 28, 2019
Stevenson, Caitlin Marie Anesthesiology Brooklyn 289201-6W May 24, 2019
Tatsas, Alon Anesthesiology Syracuse 295104-4W May 3, 2019
Atherton, Emma Susan Chiropractic West Seneca C13184-9W May 17, 2019
Chung, Jae Chiropractic Bronx C12520-5W May 17, 2019
Gadaborshev, Marina Chiropractic Middle Village C13000-7B May 17, 2019
LaCroix, Stephanie Ann Chiropractic Brooklyn C12105-5B May 17, 2019
Rockas, John Joseph Chiropractic Rochester C13217-7W May 17, 2019
Simon, Mitchell Steven Chiropractic Yonkers C13165-8W May 17, 2019
Van de Water, Lauren Taylor Chiropractic Cambridge C13204-5W May 17, 2019
Wright, Brandon Michael Chiropractic Geneseo C13208-6B May 17, 2019
Ayala-Bustamante, Everick Diagnostic Radiology New York 267626-0W May 24, 2019
Belani, Puneet Bhojraj Diagnostic Radiology, Neuroradiology New York 277401-6W May 24, 2019
Campbell, Andrew B. Diagnostic Radiology Williamsville 153691-1W May 29, 2019
Chan, Shirley Diagnostic Radiology New York 283683-1W May 28, 2019
Goldfarb, Charles Richard Diagnostic Radiology, Nuclear Medicine New York 109383-0W May 14, 2019
Greif, Eric Fabian Diagnostic Radiology Huntington 272750-1W May 24, 2019
Hedayati, Amir Diagnostic Radiology Bronx 234626-0W May 24, 2019
Mujo, Tomas Diagnostic Radiology Fayetteville 291920-7W May 24, 2019
Obedian, Michael Diagnostic Radiology New York 269912-2W May 28, 2019
Obedian, Robert Diagnostic Radiology Brooklyn 218877-9W May 24, 2019
Rosen, Ally Diagnostic Radiology Mineola 228866-0B May 24, 2019
Tong, Angela Diagnostic Radiology New York 288388-2B May 14, 2019
Well, David S. Diagnostic Radiology, Neuroradiology Brooklyn 252708-3W May 3, 2019
Dao, Theresa Bich Tran Emergency Medicine New York 289040-8W May 28, 2019
Ganguly, Sonali Emergency Medicine New York 280491-2W May 14, 2019
Leinhart, James August Emergency Medicine Cooperstown 296065-6W May 14, 2019
Livingston, William Henry, III Emergency Medicine Naples 224020-8W May 24, 2019
Moshkovich, Evgeniy V. Emergency Medicine Brooklyn 240208-9W May 24, 2019
Shekher, Manu Chandra Emergency Medicine New York 257767-4W May 28, 2019
Skomorovsky, Elena Emergency Medicine New York 285910-6W May 28, 2019
Tan, Timothy Meng-Hong Emergency Medicine New York 265759-1W May 28, 2019
Balfour, Jennifer Family Practice Bellmore 251790-2W May 24, 2019
Beharry-Mohan, Kavita C. N. Family Practice New York 295470-9W May 14, 2019
Blando, Matthew Thomas Family Practice Whitesboro 296057-3W May 14, 2019
Bostock, Deborah Jean Family Practice New York 286649-9W May 14, 2019
Hopkins, Scott Adam Family Practice New York 292677-2W May 14, 2019
Ivanov, Zhanna Alexandra Family Practice New York 295666-2W May 28, 2019
Jacobucci, Nicola Joseph Family Practice Brooklyn 296566-3W May 24, 2019
Li, Patricia Family Practice New York 281224-6W May 28, 2019
Morin, Jocelyn Mahylis Family Practice Cazenovia 291721-9W May 20, 2019
Wan, Andrew D. Family Practice White Plains 282114-8W May 24, 2019
Chepak, Ilona Internal Medicine Syracuse 297031-7W May 28, 2019
Ciechorska, Maria Internal Medicine, Hematology, Medical Oncology New York 193143-5W May 28, 2019
Cohen, Susan Lea Internal Medicine, Anesthesiology, Critical Care Medicine Mamaroneck 165186-8W May 20, 2019
DeVito, Joseph Internal Medicine New York 193455-3B May 14, 2019
Emy, John K. Internal Medicine New York 179959-2B May 14, 2019
Ess, Henry John James, IV Internal Medicine Rochester 295757-9B May 24, 2019
Henry, Michael W. Internal Medicine, Pulmonary Disease New York 208146-1B May 24, 2019
Hoffman, Miriam Beth Internal Medicine New York 258516-4W May 28, 2019
Jain, Sandeep Harbans Internal Medicine Bronx 234975-1W May 14, 2019
Kanack, Jennifer Marie Internal Medicine Rochester 295383-4W May 24, 2019
Karetny, Martha Internal Medicine Brooklyn 204060-8W May 24, 2019
Mathew, Liby Internal Medicine Middletown 249573-7B May 24, 2019
Newton, Scott William Internal Medicine Albany 274216-1W May 20, 2019
Rattner, Peter Internal Medicine, Pulmonary Disease, Critical Care Medicine New York 269977-5W May 24, 2019
Rizvi, Syed Alay Hassan Internal Medicine Stony Brook 263274-3W May 24, 2019
Shah, Alan Internal Medicine Cardiovascular Disease New York 208206-3B May 14, 2019
Tejera, Paul Manuel Internal Medicine, Endocrinology, Diabetes and Metabolism Potsdam 279414-7W May 3, 2019
Ferro, John Alfred Neurology Port Jervis 179984-0W May 24, 2019
Mueller, Kelly Donnelly Neurology Albany 268837-2W May 28, 2019
Milner, Dvorah Obstetrics/Gynecology Ithaca 212967-4W May 14, 2019
San Roman, Gustavo Adolfo Obstetrics/Gynecology Port Jefferson Stat 173068-8W May 24, 2019
Eljashev, Rachel Ophthalmology East Setauket 191401-9W May 20, 2019
Albus, Thomas Edward Orthopedic Surgery Brooklyn 290960-4B May 28, 2019
Orio, Anthony Michael Orthopedic Surgery East Syracuse 294989-9W May 24, 2019
Pomerance, Jay Forrest Orthopedic Surgery, Hand Surgery Malverne 185452-0I May 28, 2019
Samocha, Yigal Orthopedic Surgery Fishkill 286893-3B May 14, 2019
Shen, Wei Orthopedic Surgery Great Neck 278364-5B May 24, 2019
Slaughter, Douglas Alan Orthopedic Surgery New York 217718-6W May 15, 2019
Marra, Stephen Jay Otolaryngology New York 209947-1B May 14, 2019
Tahzib, Munirih Nura Pediatrics New York 215496-1W May 14, 2019
Ivanov, Yuriy Olegovich Physical Medicine/Rehabilitation Flushing 276396-9W May 14, 2019
Lione, Thomas Paul Physical Medicine/Rehabilitation Pain Management Garden City 277298-6B May 14, 2019
Penta, Pradeep Physical Medicine/Rehabilitation New York 256722-0B May 1, 2019
Blokh, Marianna Podiatry Brooklyn P06873-5I May 9, 2019
Mercado, Danielle Marie Podiatry New York P06895-8W May 10, 2019
Sharma, Gagandeep Podiatry North Bellmore P06928-7B May 10, 2019
Sumpter, Brittany Charmaine Podiatry North Syracuse P06919-6W May 9, 2019
Pohar, Surjeet Singh Radiation Oncology Manlius 219430-6W May 28, 2019
Adams, Dean Raymond Surgery, Colon/Rectal Surgery Binghamton 293639-1W May 20, 2019
Hughes, Melany Camille Surgery Stony Brook 295668-8W May 3, 2019
Miller, Brent Paul Surgery Rochester 295091-3W May 23, 2019
Peter, Amarjit David Surgery Geneva 267031-3W May 22, 2019

* 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