Subject Numbers Regarding Health Provider Authorizations
June 12, 2019
The following have been added to the list of providers authorized to treat injured workers and/or perform independent medical examinations within the New York State workers’ compensation system.
| NAME | SPECIALTY AREA OF PRACTICE | CITY OF PRACTICE | AUTHORIZATION NUMBER* | EFFECTIVE DATE |
|---|---|---|---|---|
| Carinci, Adam John | Anesthesiology, Pain Management | Rochester | 291417-4B | May 15, 2019 |
| Hernandez, Justin | Anesthesiology | Putnam Valley | 294840-4W | May 24, 2019 |
| Mata, Joel Eduardo | Anesthesiology, Pain Management | Central Islip | 280622-2W | May 24, 2019 |
| Myint, Soe | Anesthesiology | Brooklyn | 225533-9W | May 28, 2019 |
| Rothstein, Daniel | Anesthesiology, Pain Management | New York | 274814-3B | May 24, 2019 |
| Semanczuk, William Paul | Anesthesiology | Mount Kisco | 220473-3W | May 28, 2019 |
| Starr, Don Michael | Anesthesiology | Rye Brook | 185784-6W | May 28, 2019 |
| Stevenson, Caitlin Marie | Anesthesiology | Brooklyn | 289201-6W | May 24, 2019 |
| Tatsas, Alon | Anesthesiology | Syracuse | 295104-4W | May 3, 2019 |
| Atherton, Emma Susan | Chiropractic | West Seneca | C13184-9W | May 17, 2019 |
| Chung, Jae | Chiropractic | Bronx | C12520-5W | May 17, 2019 |
| Gadaborshev, Marina | Chiropractic | Middle Village | C13000-7B | May 17, 2019 |
| LaCroix, Stephanie Ann | Chiropractic | Brooklyn | C12105-5B | May 17, 2019 |
| Rockas, John Joseph | Chiropractic | Rochester | C13217-7W | May 17, 2019 |
| Simon, Mitchell Steven | Chiropractic | Yonkers | C13165-8W | May 17, 2019 |
| Van de Water, Lauren Taylor | Chiropractic | Cambridge | C13204-5W | May 17, 2019 |
| Wright, Brandon Michael | Chiropractic | Geneseo | C13208-6B | May 17, 2019 |
| Ayala-Bustamante, Everick | Diagnostic Radiology | New York | 267626-0W | May 24, 2019 |
| Belani, Puneet Bhojraj | Diagnostic Radiology, Neuroradiology | New York | 277401-6W | May 24, 2019 |
| Campbell, Andrew B. | Diagnostic Radiology | Williamsville | 153691-1W | May 29, 2019 |
| Chan, Shirley | Diagnostic Radiology | New York | 283683-1W | May 28, 2019 |
| Goldfarb, Charles Richard | Diagnostic Radiology, Nuclear Medicine | New York | 109383-0W | May 14, 2019 |
| Greif, Eric Fabian | Diagnostic Radiology | Huntington | 272750-1W | May 24, 2019 |
| Hedayati, Amir | Diagnostic Radiology | Bronx | 234626-0W | May 24, 2019 |
| Mujo, Tomas | Diagnostic Radiology | Fayetteville | 291920-7W | May 24, 2019 |
| Obedian, Michael | Diagnostic Radiology | New York | 269912-2W | May 28, 2019 |
| Obedian, Robert | Diagnostic Radiology | Brooklyn | 218877-9W | May 24, 2019 |
| Rosen, Ally | Diagnostic Radiology | Mineola | 228866-0B | May 24, 2019 |
| Tong, Angela | Diagnostic Radiology | New York | 288388-2B | May 14, 2019 |
| Well, David S. | Diagnostic Radiology, Neuroradiology | Brooklyn | 252708-3W | May 3, 2019 |
| Dao, Theresa Bich Tran | Emergency Medicine | New York | 289040-8W | May 28, 2019 |
| Ganguly, Sonali | Emergency Medicine | New York | 280491-2W | May 14, 2019 |
| Leinhart, James August | Emergency Medicine | Cooperstown | 296065-6W | May 14, 2019 |
| Livingston, William Henry, III | Emergency Medicine | Naples | 224020-8W | May 24, 2019 |
| Moshkovich, Evgeniy V. | Emergency Medicine | Brooklyn | 240208-9W | May 24, 2019 |
| Shekher, Manu Chandra | Emergency Medicine | New York | 257767-4W | May 28, 2019 |
| Skomorovsky, Elena | Emergency Medicine | New York | 285910-6W | May 28, 2019 |
| Tan, Timothy Meng-Hong | Emergency Medicine | New York | 265759-1W | May 28, 2019 |
| Balfour, Jennifer | Family Practice | Bellmore | 251790-2W | May 24, 2019 |
| Beharry-Mohan, Kavita C. N. | Family Practice | New York | 295470-9W | May 14, 2019 |
| Blando, Matthew Thomas | Family Practice | Whitesboro | 296057-3W | May 14, 2019 |
| Bostock, Deborah Jean | Family Practice | New York | 286649-9W | May 14, 2019 |
| Hopkins, Scott Adam | Family Practice | New York | 292677-2W | May 14, 2019 |
| Ivanov, Zhanna Alexandra | Family Practice | New York | 295666-2W | May 28, 2019 |
| Jacobucci, Nicola Joseph | Family Practice | Brooklyn | 296566-3W | May 24, 2019 |
| Li, Patricia | Family Practice | New York | 281224-6W | May 28, 2019 |
| Morin, Jocelyn Mahylis | Family Practice | Cazenovia | 291721-9W | May 20, 2019 |
| Wan, Andrew D. | Family Practice | White Plains | 282114-8W | May 24, 2019 |
| Chepak, Ilona | Internal Medicine | Syracuse | 297031-7W | May 28, 2019 |
| Ciechorska, Maria | Internal Medicine, Hematology, Medical Oncology | New York | 193143-5W | May 28, 2019 |
| Cohen, Susan Lea | Internal Medicine, Anesthesiology, Critical Care Medicine | Mamaroneck | 165186-8W | May 20, 2019 |
| DeVito, Joseph | Internal Medicine | New York | 193455-3B | May 14, 2019 |
| Emy, John K. | Internal Medicine | New York | 179959-2B | May 14, 2019 |
| Ess, Henry John James, IV | Internal Medicine | Rochester | 295757-9B | May 24, 2019 |
| Henry, Michael W. | Internal Medicine, Pulmonary Disease | New York | 208146-1B | May 24, 2019 |
| Hoffman, Miriam Beth | Internal Medicine | New York | 258516-4W | May 28, 2019 |
| Jain, Sandeep Harbans | Internal Medicine | Bronx | 234975-1W | May 14, 2019 |
| Kanack, Jennifer Marie | Internal Medicine | Rochester | 295383-4W | May 24, 2019 |
| Karetny, Martha | Internal Medicine | Brooklyn | 204060-8W | May 24, 2019 |
| Mathew, Liby | Internal Medicine | Middletown | 249573-7B | May 24, 2019 |
| Newton, Scott William | Internal Medicine | Albany | 274216-1W | May 20, 2019 |
| Rattner, Peter | Internal Medicine, Pulmonary Disease, Critical Care Medicine | New York | 269977-5W | May 24, 2019 |
| Rizvi, Syed Alay Hassan | Internal Medicine | Stony Brook | 263274-3W | May 24, 2019 |
| Shah, Alan | Internal Medicine Cardiovascular Disease | New York | 208206-3B | May 14, 2019 |
| Tejera, Paul Manuel | Internal Medicine, Endocrinology, Diabetes and Metabolism | Potsdam | 279414-7W | May 3, 2019 |
| Ferro, John Alfred | Neurology | Port Jervis | 179984-0W | May 24, 2019 |
| Mueller, Kelly Donnelly | Neurology | Albany | 268837-2W | May 28, 2019 |
| Milner, Dvorah | Obstetrics/Gynecology | Ithaca | 212967-4W | May 14, 2019 |
| San Roman, Gustavo Adolfo | Obstetrics/Gynecology | Port Jefferson Stat | 173068-8W | May 24, 2019 |
| Eljashev, Rachel | Ophthalmology | East Setauket | 191401-9W | May 20, 2019 |
| Albus, Thomas Edward | Orthopedic Surgery | Brooklyn | 290960-4B | May 28, 2019 |
| Orio, Anthony Michael | Orthopedic Surgery | East Syracuse | 294989-9W | May 24, 2019 |
| Pomerance, Jay Forrest | Orthopedic Surgery, Hand Surgery | Malverne | 185452-0I | May 28, 2019 |
| Samocha, Yigal | Orthopedic Surgery | Fishkill | 286893-3B | May 14, 2019 |
| Shen, Wei | Orthopedic Surgery | Great Neck | 278364-5B | May 24, 2019 |
| Slaughter, Douglas Alan | Orthopedic Surgery | New York | 217718-6W | May 15, 2019 |
| Marra, Stephen Jay | Otolaryngology | New York | 209947-1B | May 14, 2019 |
| Tahzib, Munirih Nura | Pediatrics | New York | 215496-1W | May 14, 2019 |
| Ivanov, Yuriy Olegovich | Physical Medicine/Rehabilitation | Flushing | 276396-9W | May 14, 2019 |
| Lione, Thomas Paul | Physical Medicine/Rehabilitation Pain Management | Garden City | 277298-6B | May 14, 2019 |
| Penta, Pradeep | Physical Medicine/Rehabilitation | New York | 256722-0B | May 1, 2019 |
| Blokh, Marianna | Podiatry | Brooklyn | P06873-5I | May 9, 2019 |
| Mercado, Danielle Marie | Podiatry | New York | P06895-8W | May 10, 2019 |
| Sharma, Gagandeep | Podiatry | North Bellmore | P06928-7B | May 10, 2019 |
| Sumpter, Brittany Charmaine | Podiatry | North Syracuse | P06919-6W | May 9, 2019 |
| Pohar, Surjeet Singh | Radiation Oncology | Manlius | 219430-6W | May 28, 2019 |
| Adams, Dean Raymond | Surgery, Colon/Rectal Surgery | Binghamton | 293639-1W | May 20, 2019 |
| Hughes, Melany Camille | Surgery | Stony Brook | 295668-8W | May 3, 2019 |
| Miller, Brent Paul | Surgery | Rochester | 295091-3W | May 23, 2019 |
| Peter, Amarjit David | Surgery | Geneva | 267031-3W | May 22, 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.
Any questions regarding the authorized lists should be referred to the Medical Director’s Office at 1 (800) 781-2362.
Clarissa M. Rodriguez
Chair