Subject Numbers Regarding Health Provider Authorizations

Authorization No. 211807-3W

July 27, 2020

Pursuant to Workers' Compensation Law Section 13-d(2)(a), the Chair of the New York State Workers' Compensation Board has exercised her authority to remove Dr. Kevin Custis' authorization to treat injured workers in the New York State workers' compensation system effective July 22, 2020. Dr. Custis' authorization to treat injured workers was previously temporarily suspended effective April 2, 2018 (Subject Number 046-1052).

Dr. Custis' last known address is:

887B E New York Avenue
Brooklyn, New York 11203

The Chair's designee's investigation has revealed that Dr. Custis applied to surrender his license to practice medicine in New York State in full satisfaction of the charges against him, that on or about March 18, 2019, in the New York Supreme Court - Kings County Criminal Part, he was convicted of seven felonies.

Dr. Custis 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). Reports submitted by Dr. Custis for services rendered prior to April 2, 2018, are valid but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Custis for services rendered prior to April 2, 2018, should not be denied due to the removal of his authorization.

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