Subject Numbers Regarding Health Provider Authorizations

Authorization No. 190556-1B

December 6, 2016

Please be advised that Dr. Horacio Capote has resigned his authorizations to treat injured workers and to perform independent medical examinations in the New York State workers’ compensation system effective December 2, 2016. Dr. Capote’s last known practice addresses are 3980 Sheridan Drive, Amherst, New York 14226, and Dent Neurologic Group, 200 Sterling Drive, Orchard Park, New York 14127.

Dr. Capote is prohibited from rendering treatment and care to injured workers and from performing independent medical examinations. Reports submitted by Dr. Capote for services rendered prior to December 2, 2016, are valid, but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Capote for services rendered prior to December 2, 2016, should not be denied due to the resignation of his authorizations.

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