Subject Numbers Regarding Health Provider Authorizations

Authorization No. 222886-4W

October 21, 2020

Please be advised that Dr. Andrew J. Fallis has resigned his authorization to treat injured workers in the New York State workers’ compensation system effective October 13, 2020. Dr. Fallis’ last known practice address is:

Beth Israel Med Group
55 East 34th Street
New York, New York 10016

Dr. Fallis 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. Fallis for services rendered prior to October 13, 2020, are valid but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Fallis for services rendered prior to October 13, 2020, should not be denied due to his resignation.

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