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Subject Number 046-1269 Changes to the List of Health Care Providers Authorized to Render Services to Injured Workers Under the Workers' Compensation La

Subject Numbers Regarding Health Provider Authorizations

February 27, 2020

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
Amajoyi, Robert Valley Stream 273853-2W December 16, 2019
August, Lawrence Edward Brooklyn C01688-3W December 16, 2019
Balderman, Samuel Calvin Buffalo 137463-6W December 16, 2019
Bencardino, Jenny Teresa Jericho 238787-6W December 16, 2019
Berrios, Ramon Marietta 127718-5W December 16, 2019
Bozic, Stanimir Pound Ridge 138853-7W December 16, 2019
Campbell, Christina L. Johnson City 291037-0W December 16, 2019
Chundru Usha Cresskill 239960-8W December 16, 2019
Chung, Jae Won Edgewater 234823-3W December 16, 2019
Dave, Vinnidhy New York 275556-9W December 16, 2019
Denaro, Jack A. New York 110624-4W December 16, 2019
Diamond, Burton S. Great Neck 095943-7W December 16, 2019
Faimon, Jack I. Fresh Meadows C03739-2W December 16, 2019
Ferguson, Ruth Southampton 091188-3W December 16, 2019
Fine, Leslie Hewlett Harbor 084345-8W December 16, 2019
Folger, Walter Howland Albany 209781-4W December 16, 2019
Garvey, Julius W. Fresh Meadows 107943-3W December 16, 2019
Gebert, John Kevin Mechanicville 134994-3W December 16, 2019
Gelbard, Bernard Malone 128127-8W December 16, 2019
Giordano, John Joseph Hauppauge 089309-9W December 16, 2019
Gray, Cynthia E. White Plains 144432-2W December 16, 2019
Greenberg, Robert H. Bronx C04023-0W December 16, 2019
Gutierrez, Silvia M. Miami Beach 164246-1W December 16, 2019
Harder, Joseph A. Bellport 070487-4W December 16, 2019
Huang, Ching-Huang Warwick 164972-2W December 16, 2019
Jacobs, Fred I. Saratoga Springs P02814-3W December 16, 2019
Jubelt, Burk Syracuse 116715-4W December 16, 2019
Kapasi, Amarish R. Atlanta 223511-7W December 16, 2019
Kephart, Phyllis A. Prattsburgh 181992-9W December 16, 2019
Khan, Arfa Jericho 109926-6W December 16, 2019
Kiefer, Daniel George Orlando 239801-1W December 16, 2019
Kim, In Tae Rochester 274769-9W December 16, 2019
Koda, Emi Amy Orchard Park 290892-9W December 16, 2019
Leggio, Joanne Maria Albany C05493-4W December 16, 2019
Litchmore, Trevor Alexander Schenectady 193012-2W December 16, 2019
Lowinson, Joyce H. New York 091521-5W December 16, 2019
Maglione, Paul J. Ossining P02544-6W December 16, 2019
Majithia, Narendra H. Myrtle Beach 134178-3W December 16, 2019
Mendelsohn, Frederick Sydney New York 083923-3W December 16, 2019
Milstein, Harold Chatham 134763-2W December 16, 2019
Mitchell, Thomas R. Port Myers 180983-9W December 16, 2019
Naidu, Sandeep Eden Prairie 247777-6W December 16, 2019
Painton, J. Frederick, Jr. Williamsville 094668-1W December 16, 2019
Palmer, Kenneth David Houston 188445-1B December 16, 2019
Peralo, Charles Anthony Rock Hill 197721-4W December 16, 2019
Rainstein, Miguel A. Estero 133539-7W December 16, 2019
Ratanawongsa, Boonlua Olean 118639-4W December 16, 2019
Rosenbaum, Siegfried Floral Park 109435-8W December 16, 2019
Seaman, Gideon La Jolia 081366-7W December 16, 2019
Semel-Concepcion, Jennifer J. Port Jefferson 193282-1W December 16, 2019
Shetty, Kadandale Ravindranath Manhasset 110501-4W December 16, 2019
Simon, Sidney White Plains 070551-7W December 16, 2019
Singh, Monika Northborough 255848-4W December 16, 2019
So, Rosa Sy Brooklyn 111941-1W December 16, 2019
Sonoda, Myung Park Tuckahoe 103194-7W December 16, 2019
Spiegelman, Morton Rydal 072601-8W December 16, 2019
Stampur, Henry L. Port Chester 112615-0W December 16, 2019
Stanistreet, Bryan J. Rochester 276576-6W December 16, 2019
Stein, Alfred M. Williamsville 082531-5W December 16, 2019
Stewart, Edmunde Andrew Cameron Port Jefferson 093356-4B December 16, 2019
Sun, Yue Albany 282844-0W December 16, 2019
Tolge, Bruno Paul Schenectady 088151-6W December 16, 2019
Tomy, Mercy Kuttentharappel Williamsville 285204-4W December 16, 2019
Trimboli, Joseph Rocco Victor C12892-8W December 17, 2019
Vairavamurthy, Darshan Wimal Middletown 269329-9W December 17, 2019
Villafuerte, Ceferino Reyes Greenwich 105492-3W December 17, 2019
Walker, James T. Centerport 143375-4W December 17, 2019
Weiser, Stephen M. Pleasantville 131791-6W December 17, 2019
Weiss, Jerome Boynton Beach 043098-3W December 17, 2019
Wiedman, Melvin L. Manhasset 082495-3W December 17, 2019
Wilcox, Guy Hartley Sauquoit 131403-8W December 17, 2019
Woo, Myung Shik New York 126727-7W December 17, 2019
Woolf, George Middletown 084949-7W December 17, 2019
Yang, Chin Tsun Rockville Centre 117984-5W December 17, 2019
Zakow, Peter K. Poughkeepsie 195399-1W December 17, 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.

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