Subject Numbers Regarding Health Provider Authorizations

Authorization No. C06682-1B

June 8, 2021

Please be advised that Dr. Philip Thomas Dontino has resigned his authorizations to treat injured workers and perform independent medical examinations in the New York State workers' compensation system effective May 28, 2021. Dr. Dontino's last known practice address is:

1 Oxford Road, Suite 200
New Hartford, New York 13413

Dr. Dontino is prohibited from rendering treatment and care to injured workers, from performing independent medical examinations, and from conducting reviews of records regarding variance requests pursuant to 12 NYCRR § 324.3(b)(2)(ii)(a). Reports submitted by Dr. Dontino for services rendered prior to May 28, 2021, are valid but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Dontino for services rendered prior to May 28, 2021, 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.