Subject Numbers Regarding Health Provider Authorizations
Authorization No. 209426-6W
December 30, 2019
Pursuant to Workers' Compensation Law Section 13-d(4), the Chair of the New York State Workers' Compensation Board has exercised her authority to temporarily suspend Dr. Hamid Mostafavi’s authorization to treat injured workers within the New York State workers’ compensation system effective December 30, 2019. Dr. Mostafavi's last known business address is:
600 Northern Boulevard, Suite 300
Great Neck, New York 11021
The Chair’s designee’s investigation has revealed that, despite multiple written requests, Dr. Mostafavi has failed and refused to provide the Board with proof of reimbursement of the sum of $8,108.90 to claimant’s private health insurer, which sum having also been paid to Dr. Mostafavi by the claimant’s workers’ compensation carrier for the same treatment.
As a result of the foregoing, the Chair believes that Dr. Mostafavi may be guilty of misconduct under WCL §13-d(2)(f) for the refusal to produce “any relevant book or paper concerning his or her conduct under any authorization granted to him or her under this chapter.”
Dr. Mostafavi is prohibited from rendering treatment and care to injured workers and from conducting reviews of records regarding variance requests pursuant to 12 NYCRR § 324.3(b)(2)(ii)(a) while his authorization is temporarily suspended. Reports submitted by Dr. Mostafavi for services rendered prior to December 30, 2019, are valid but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Mostafavi for services rendered prior to December 30, 2019, should not be denied due to the suspension of his authorization.
This suspension remains in effect until further notice. Any questions regarding the authorized lists should be referred to the Medical Director’s Office at 1 (800) 781-2362.
Clarissa M. Rodriguez