Subject Numbers Regarding Health Provider Authorizations

Authorization No. 125213-9W

October 26, 2021

Pursuant to Workers' Compensation Law Sections 13-b and 13-d, the Chair of the New York State Workers' Compensation Board has exercised her authority to remove Dr. Andresito B. Pacis' authorization to treat injured workers in the New York State workers' compensation system effective October 22, 2021. This action is non-disciplinary in nature. Dr. Pacis' last known business address is:

Mosholu Park Radiology, P.C.
3130 Grand Concourse, Suite 1P
Bronx, New York 10458

The Chair's designee's investigation has revealed that Dr. Pacis has voluntarily permanently surrendered his license to practice medicine in New York State to the Board for Professional Misconduct pursuant to Public Health Law § 230.13, effective October 22, 2021. This action was non-disciplinary in nature.

Dr. Pacis 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. Pacis for services rendered prior to October 22, 2021, are valid but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Pacis for services rendered prior to October 22, 2021, 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.