Subject Numbers Regarding Health Provider Authorizations
January 8, 2008
The following medical doctors, surgeons, and osteopaths who were authorized by the New York State Workers' Compensation Board to conduct independent medical examinations of injured or ill workers have failed to renew their board certification with the American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA), as the case may be.
Those providers as listed below are no longer compliant with WCL §137 or 12 NYCRR §300.2(b)(3), which require such board certification in order to continue to be IME authorized. Accordingly, each individual's respective authorization to conduct independent medical examinations has been revoked until such time that said provider renews his or her board certification and submits an application for authorization with adequate and appropriate proof to that effect. The providers' authorization to treat workers' compensation claimants, if so authorized, is not affected by this revocation.
| NAME | AUTHORIZATION NUMBER | EFFECTIVE DATE OF REVOCATION |
|---|---|---|
| Autz, Arthur Louis | 186518-7W | 01/01/05 |
| Battaglia, Michael Joseph | 182014-1W | 01/01/05 |
| Bauer, Steven Robert | 207738-6W | 01/01/07 |
| Blum, Dwight C | 137492-5W | 01/01/07 |
| Brandel, Zev | 207019-1W | 01/01/05 |
| Ciuffo, Joseph J | 155718-0W | 01/01/05 |
| Engel, Peter Bruce | 183422-5W | 01/01/05 |
| Futterman, Bennett Alan | 143677-3W | 01/01/07 |
| Gelin, Emmanuel | 192203-8W | 01/01/05 |
| Guidarelli, Anthony Fred | 105592-0W | 01/01/07 |
| Gustin, Gabriel | 213265-2W | 01/01/05 |
| Karmazin, Yevgeniya | 198112-5W | 01/01/07 |
| Kay, Bruce Saul | 136630 | 01/01/05 |
| Khokhar, Imtiaz A | 197453 | 08/02/07 |
| Kjoller, Jane Laura | 194237-4W | 01/01/05 |
| Larosa, Joseph Michael | 181747-7W | 01/01/05 |
| Luna Vega, Alberto Rodolfo | 171809-7W | 07/02/07 |
| Makram, Cherif | 159208-8W | 07/02/05 |
| Mehta, Mrugendra Indravadan | 224413 | 07/02/07 |
| Moore, Donald E | 157236-1W | 01/01/05 |
| O'Brien, Thomas Gerard | 210513-8W | 01/01/07 |
| Oh, Chung Hyun | 111469-3W | 07/02/07 |
| Padial, Michael S | 191639 | 01/01/05 |
| Peer, Richard Milton | 106941-8W | 07/02/06 |
| Reddy, Nirmala M | 167789-7W | 01/01/05 |
| Santiago, Ricardo Nakadomari | 202437-0W | 07/01/07 |
| Shanon, Roy Mark | 175599-0W | 01/01/05 |
| Verdini, John Patrick | 179399-1W | 01/01/05 |
| Wieder, Harvey | 206669-4W | 01/01/05 |
| Zuo, Hailiu | 192825-8W | 01/01/05 |
Any reports of independent medical examination conducted prior to the provider's respective revocation date of his or her authorization are permitted and the examiner is entitled to payment. Further, said provider may provide testimony and/or deposition concerning independent medical exams he or she concluded prior to revocation date.
Any questions regarding this matter should be referred to the Office of General Counsel at (518) 486-9564.
Zachary S. Weiss
Chair