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Workers' Compensation Board

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New York State
Workers' Compensation Board
OFFICE OF THE CHAIR
328 State Street  Schenectady, New York 12305
Governor Andrew M. Cuomo


Subject No. 046-743

Changes to the List of Health Care Providers Authorized to
Render Services to Injured Workers
Under the Workers' Compensation Law

Date: December 8, 2014

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
Amaravadi, Kameswari Fresh Meadows 191527-1W September 9, 2014
Balsam, Richard Albany 097753-8W September 10, 2014
Baradaran, Asadolah Middletown 192401-8W September 9, 2014
Bear, George New York 092799-6W September 9, 2014
Bhatt, Kaje Binghamton 122483-1W September 9, 2014
Booth, Clayburn Wilson 091157-8W September 9, 2014
Butsunturn, Chairat Niagara Falls 111170-7W September 9, 2014
Cavoli, Michael Ralph Hempstead C00051-5W September 9, 2014
Chaumin, Yanick Bronx 156363-4W September 9, 2014
Cheruvu, Sreekrishna Williamsville 164503-5W September 9, 2014
Choi, Young Chappaqua 148680-2W September 9, 2014
Culbertson, Charles Pittsford 137905-6W September 9, 2014
Davidoff, Allen Harrison 110706-9W September 9, 2014
Derosa, Patrick Garden City 129321-6W September 10, 2014
Deshpande, Satish Scarsdale 186263-0W September 9, 2014
Dubin, Arthur Melville 049769-3W September 9, 2014
Gale, Kenneth Syracuse 046417-2B September 9, 2014
Garg, Dharam Clarence Center 157914-3W September 9, 2014
Gillespie, David Rochester 249876-4W September 9, 2014
Goldberg, Gary Forest Hills C02005-9W September 9, 2014
Goldberg, Max Lawrence 100688-1W September 9, 2014
Jimenez, Victor New York 190671-8W September 9, 2014
Kappel, Stephen Sunnyside S11867-9W September 9, 2014
Kelly, Raymond Queensbury 076395-3W September 9, 2014
Khokhar, Omar Batavia 140294-0W September 9, 2014
King, Charles Albion 177324-1W September 9, 2014
Korn, Martin L. Larchmont 167602-2W November 20, 2014
Krause, Kurt Elmira 168944-7W September 9, 2014
Lasker, Roz New York 161205-0W September 9, 2014
Lembo, Stephen Smithtown C09615-8W September 9, 2014
Lipton, Ross Port Jefferson 202189-7W September 9, 2014
Lomotan, Aniceto Troy 111404-0W September 9, 2014
Luft, Richard Brooklyn 105450-1W September 9, 2014
Madden, Robert Bronxville 085861-3W September 9, 2014
Maggio, John New York 105306-5W September 9, 2014
Marcus, Robert Hastings On Hudson  070518-6W September 9, 2014
Martin, Sidney Smithtown 078039-5W September 9, 2014
Mass, Anne Pleasantvilled 176662-5W September 9, 2014
McAndrew, John Kingston 178441-2W September 9, 2014
Niceta, Piero New Rochelle 108238-7W September 9, 2014
Packer, Arnold Brooklyn 077098-2W September 9, 2014
Perkes, Edward Garden City 128301-9W September 9, 2014
Ramakrishna, Byranna Islandia 115638-9W September 9, 2014
Ramirez-Santisteban, Gilberto New York 080612-5W September 9, 2014
Ravich, Lawrence Floral Park 071445-1W September 9, 2014
Ray, William Ronkonkoma C04182-4B September 9, 2014
Reich, Amy Irvington C08702-5W September 9, 2014
Rivkin, Matthew Goshen 095015-4W September 9, 2014
Rosen, Carl Great Neck 086703-6W September 9, 2014
Rudolph, Lionel Fayetteville 073452-5B September 9, 2014
Schwartz, Ammiel Brewster 077866-2W September 9, 2014
Sedlis, Alexander Brooklyn 077058-6W September 9, 2014
Sharma, Rama New York 221215-7W September 9, 2014
Shifrin, Harold Great Neck 074773-3W September 9, 2014
Soto, Eliezer New York 259559-3B September 9, 2014
Spath, Thomas New Hartford 083319-4W September 9, 2014
Sreekrishnia, M. Cheruvu Williamsville 164503-5W September 9, 2014
Sturtz, George Gouverneur 077411-7W September 9, 2014
Surace, Daniel Middle Island C00345-1W September 9, 2014
Vazquez, Manuel Pelham 098365-0W September 9, 2014
Vicente, Socorro Port Jefferson 103139-2W September 9, 2014
Weissman, Michael B. Port Jefferson Station 118629-5W July 12, 2013
Wilkins, Richard Pittsford 166654-4W September 9, 2014
Wolcott, Richard Waverly C11641-0W September 9, 2014

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

 

Robert E. Beloten
Chair