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Subject Number 046-649 Newly Authorized Health Care Providers Approved to Render Services to Injured Workers Under the Workers' Compensation Law

Subject Numbers Regarding Health Provider Authorizations

November 14, 2013

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
AUTHORIZATION
NUMBER*
EFFECTIVE
DATE
COSTA ANA CRISTINA ANESTHESIOLOGY 263383-2W 10/3/2013
CURIA LUCIANA MARIA ANESTHESIOLOGY 268811-7W 10/7/2013
PERDUE MARY CRISTIN ANESTHESIOLOGY 264248-6B 10/10/2013
TRAN NOBUYUKI-HAI THANH ANESTHESIOLOGY 268530-3W 10/10/2013
EASTER LAURIE MICHELLE ANESTHESIOLOGY 270280-1W 10/23/2013
BRECKENRIDGE MATTHEW L ANESTHESIOLOGY 269524-5W 10/24/2013
DUNST RYAN MATTHEW ANESTHESIOLOGY 267541-1W 10/24/2013
FOSTER CRISTA-GAYE NICOLE ANESTHESIOLOGY 264978-8W 10/24/2013
GUELI SARAH LOUISE ANESTHESIOLOGY 267072-7W 10/24/2013
PENA JOSE A ANESTHESIOLOGY 218573-4W 10/24/2013
RASHID ZARZINA T ANESTHESIOLOGY 244639-1W 10/24/2013
MOBEEN JAFFER ANESTHESIOLOGY 256414-4W 10/25/2013
SATTERFIELD JOHN MYRON ANESTHESIOLOGY 267611-2W 10/25/2013
KUMAR KANUPRIYA ANESTHESIOLOGY 249445-8W 10/29/2013
KIRKSEY MEGHAN ALIDA ANESTHESIOLOGY 265043-0W 10/29/2013
POONIA AMIT ANESTHESIOLOGY 269042-8W 10/29/2013
FENIG ARIELLE OCHOA ANESTHESIOLOGY, PAIN MANAGEMENT 251352-1W 10/8/2013
HASKINS STEPHEN CALEB ANESTHESIOLOGY, PAIN MANAGEMENT 254272-8W 10/11/2013
DEMESMIN DIDIER ANESTHESIOLOGY, PAIN MANAGEMENT 228550-0W 10/30/2013
JAFRI SYED ZAHEER ABBAS CARDIOVASCULAR 234581-7B 10/25/2013
DRESSEL CHRISTOPHER ALAN CHIROPRACTIC C12287-1W 10/11/2013
LEE DONG HWAN CHIROPRACTIC C12358-0W 10/11/2013
MARINO LEONARD NICHOLAS CHIROPRACTIC C07221-7B 10/11/2013
RUTKOWSKI STEPHEN THEODORE CHIROPRACTIC C06887-6W 10/11/2013
SADOVNIK NOAM CHIROPRACTIC C10883-9B 10/11/2013
DECKELBAUM SCOTT HOWARD DERMATOLOGY 235559-2W 10/16/2013
BALLARD LUKE JUSTIN DIAGNOSTIC RADIOLOGY 267584-1W 10/16/2013
BALLARD GENEVA RANDALL DIAGNOSTIC RADIOLOGY 267509-8W 10/16/2013
BUONO DARREN MICHAEL DIAGNOSTIC RADIOLOGY 269557-5W 10/25/2013
CARTER SION WILLIAM DIAGNOSTIC RADIOLOGY 269144-2W 10/25/2013
COTTRELL JEFFREY RYAN DIAGNOSTIC RADIOLOGY 269198-8W 10/25/2013
BARAN GALINA DIAGNOSTIC RADIOLOGY 233203-9W 10/25/2013
KARIMI SARA DIAGNOSTIC RADIOLOGY 210909-8W 10/25/2013
HUSSIEN AMIRA DIAGNOSTIC RADIOLOGY 267820-9B 10/29/2013
ELGORT STELLA DIAGNOSTIC RADIOLOGY 264062-1W 10/29/2013
FODERA VITO DIAGNOSTIC RADIOLOGY 264556-2W 10/30/2013
SOEHNLEIN STEPHANIE LYNN DIAGNOSTIC RADIOLOGY 264892-1W 10/31/2013
JIAO RICHARD XINYU DIAGNOSTIC RADIOLOGY, NEURORADIOLOGY 256383-1W 10/1/2013
KHORSANDI AZITA DIAGNOSTIC RADIOLOGY, NEURORADIOLOGY 194066-7W 10/29/2013
MELTZER DANIEL ERIC DIAGNOSTIC RADIOLOGY, NEURORADIOLOGY 219527-9W 10/29/2013
BERNSTEIN PETER SAMUEL DIAGNOSTIC RADIOLOGY, VASCULAR AND INTERVENTIONAL RADIOLOGY 230597-7W 10/25/2013
WEISBLUM LEWIS SAMUEL DIAGNOSTIC RADIOLOGY, VASCULAR AND INTERVENTIONAL RADIOLOGY 181125-6W 10/29/2013
WILLIAMS DARYL WESLEY EMERGENCY MEDICINE 270099-5W 10/3/2013
ALBERT JANINE CLAIRE EMERGENCY MEDICINE 270623-2W 10/3/2013
MARTINS LYNDA EMERGENCY MEDICINE 226517-1W 10/3/2013
HAMDANI MOHAMMAD ADNAAN EMERGENCY MEDICINE 271635-5W 10/3/2013
MATHEW JOHN EMERGENCY MEDICINE 243046-0W 10/16/2013
GAMPEL NESHE E EMERGENCY MEDICINE 250618-6W 10/16/2013
SAMUEL STEVEN EMERGENCY MEDICINE 238889-0W 10/16/2013
CHURCH ADAM L EMERGENCY MEDICINE 194348-9W 10/16/2013
ELBERGER SCOTT EMERGENCY MEDICINE 134689-9W 10/16/2013
HADPAWAT REDA EMERGENCY MEDICINE 240258-4W 10/16/2013
MACK IAN ANDREW EMERGENCY MEDICINE 253450-1W 10/16/2013
FAZIO FRANK MICHAEL EMERGENCY MEDICINE 245406-4W 10/16/2013
BETTER LISA STEPHANIE EMERGENCY MEDICINE 216675-9B 10/25/2013
SCHREFFLER SUSAN MARIA EMERGENCY MEDICINE 271557-1W 10/29/2013
FROGEL DANIEL M EMERGENCY MEDICINE, INTERNAL MEDICINE 245689-5W 10/16/2013
ECKBERG PETER HAROLD FAMILY PRACTICE 258829-1W 10/3/2013
BLANCO ANA MARIA G FAMILY PRACTICE 261981-5W 10/3/2013
KOPPENHEFFER PETER BROOKS FAMILY PRACTICE 269392-7W 10/3/2013
VINAYAGASUNDARAM BHANUMATHY FAMILY PRACTICE 240741-9W 10/7/2013
LEIBOVICI MONICA FAMILY PRACTICE 269306-7W 10/9/2013
HOSAKA MIA FAMILY PRACTICE 271133-1W 10/9/2013
WISE ALLYSON CHRISTINE FAMILY PRACTICE 271027-5W 10/9/2013
CARTER DANIELLE MARIE FAMILY PRACTICE 268421-5B 10/9/2013
LOOMIS JAMES A FAMILY PRACTICE 271012-7W 10/10/2013
MAHON HIROMI KIMURA FAMILY PRACTICE 270882-4W 10/15/2013
LIEU JASON FAMILY PRACTICE 271145-5W 10/15/2013
FRISELLA PATRIZIO DOMENICO FAMILY PRACTICE 255862-5B 10/16/2013
BLUEMKE-MACKOFF ROBIN CINDY FAMILY PRACTICE 209242-7W 10/16/2013
SPITZER MATTHEW COOK FAMILY PRACTICE 254336-1W 10/16/2013
ASHOK MALA FAMILY PRACTICE 268667-3W 10/23/2013
MANGIONE MICHAEL THOMAS JR FAMILY PRACTICE 265117-2W 10/29/2013
MATIER JENNIFER MICHALIK FAMILY PRACTICE 262061-5W 10/29/2013
AVELLINI JAMES R GENERAL PRACTICE 148049-0W 10/1/2013
KUO KUANG HUNG GENERAL PRACTICE 270413-8W 10/16/2013
KAROFF THOMAS MICHAEL INTERNAL MEDICINE 243062-7I 10/3/2013
TERESSA GETU GONFA INTERNAL MEDICINE 271359-2W 10/3/2013
PETER RENNY VALAMPARAMBIL INTERNAL MEDICINE 271710-6W 10/3/2013
FLORES RONALD AUGUSTINE A INTERNAL MEDICINE 271282-6W 10/3/2013
SAW THAZIN INTERNAL MEDICINE 212936-9W 10/8/2013
LALDIN JOHN SAMUEL INTERNAL MEDICINE 271121-6W 10/8/2013
GEWIRTZ MICHAEL FREDERICK INTERNAL MEDICINE 173953-1W 10/16/2013
SPEAR ALISON HEATHER INTERNAL MEDICINE 228265-5B 10/24/2013
BELL RYAN ALEXANDER INTERNAL MEDICINE 269388-5B 10/25/2013
NICI ANTHONY JOSEPH INTERNAL MEDICINE 257646-0B 10/25/2013
COHEN NELLY INTERNAL MEDICINE 233371-4W 10/29/2013
ROTH MARIAM INTERNAL MEDICINE 271074-7W 10/29/2013
NAGESHWAR PRASHANT KUMAR INTERNAL MEDICINE 270985-5W 10/30/2013
DONAHOE SEAN M INTERNAL MEDICINE, CARDIOVASCULAR 240329-3W 10/3/2013
PATEL RAJOO CHITTARANJAN INTERNAL MEDICINE, CARDIOVASCULAR 196837-9W 10/3/2013
WANG LORI AMY INTERNAL MEDICINE, ENDOCRINOLOGY, DIABETES AND METABOLISM 220095-4W 10/8/2013
THOSANI AMAR JITENDRA INTERNAL MEDICINE, GASTROENTEROLOGY 246893-2B 10/3/2013
NAUTIYAL PREETI INTERNAL MEDICINE, INFECTIOUS DISEASES 224753-4W 10/8/2013
GAFFNEY-ADAMS ALEXEA MAKIYA INTERNAL MEDICINE, INFECTIOUS DISEASES, PEDIATRICS 266926-5W 10/3/2013
GILL GAGANDEEP INTERNAL MEDICINE, PEDIATRICS 270751-1W 10/3/2013
RUBINSTEIN ADAM LANCE INTERNAL MEDICINE, PEDIATRICS 219350-6I 10/30/2013
ALAM ABDULKADER INTERNAL MEDICINE, PSYCHIATRY 238375-0W 10/3/2013
PAUL MANJU POVATHUMVEEDAN INTERNAL MEDICINE, PULMONARY DISEASES, CRITICAL CARE 271077-0W 10/3/2013
SANDERS AMY ELAINE NEUROLOGY 243608-7W 10/10/2013
SACHDEV-SINGH NAUNIHAL NEUROLOGY 135528-8I 10/15/2013
SHASTRI KALYAN KANDUKURTHI NEUROLOGY 267346-5W 10/29/2013
BABIN DAVID RANDOLPH NUCLEAR MEDICINE, DIAGNOSTIC RADIOLOGY 269412-3W 10/25/2013
KELTY ROBERT WALTER OBSTETRICS/GYNECOLOGY 184827-4W 10/1/2013
VARUGHESE-RAJU JOYCE OBSTETRICS/GYNECOLOGY, GYNECOLOGIC ONCOLOGY 270464-1W 10/3/2013
DWECK MONICA MICHELE OPHTHALMOLOGY 173216-3W 10/8/2013
CARRUTH BRYANT PAUL OPHTHALMOLOGY 260147-4W 10/29/2013
THOMAN MARIE-EVE CHRISTINE OPHTHALMOLOGY 254981-4W 10/29/2013
ABBAS NAUSHEEN OPHTHALMOLOGY 268882-8W 10/30/2013
MA KATHERINE CRAIG ORTHOPEDIC SURGERY 269535-1W 10/1/2013
KUNKLE HERBERT L ORTHOPEDIC SURGERY 270411-2W 10/8/2013
KIM JAEHON MICHAEL ORTHOPEDIC SURGERY 268733-3W 10/15/2013
SCHIEBERT STEVEN SOKOLOV ORTHOPEDIC SURGERY 257063-8W 10/16/2013
HASSAN SHEREF E ORTHOPEDIC SURGERY 261137-4W 10/16/2013
HIP-FLORES JULES DAVID ORTHOPEDIC SURGERY 270327-0W 10/29/2013
ODA NINOS ORTHOPEDIC SURGERY 271683-5W 10/29/2013
BLAKE DEIDRE M ORTHOPEDIC SURGERY 256896-2W 10/30/2013
SOLES GILLIAN LS ORTHOPEDIC SURGERY 270393-2W 10/31/2013
KADIYALA RAJENDRA KUMAR ORTHOPEDIC SURGERY, HAND SURGERY 270923-6B 10/15/2013
PODZIMEK JANA OTOLARYNGOLOGY 270370-0B 10/16/2013
VARGA-HUETTNER VICTORIA EVA OTOLARYNGOLOGY 270705-7W 10/21/2013
CABALLERO TANIA MARIA PEDIATRICS 270552-3W 10/29/2013
LEE ERIC PHYSICAL MEDICINE/REHABILITATION 264765-9B 10/10/2013
LERCHER KIRK PHYSICAL MEDICINE/REHABILITATION 269305-9W 10/10/2013
FUSCO HEIDI NICOLE PHYSICAL MEDICINE/REHABILITATION 264468-0W 10/10/2013
MATARRESE MARISSA RAE PLASTIC SURGERY 268664-0W 10/31/2013
CHEPURNAYA IRYNA PSYCHIATRY 225037-1W 10/30/2013
RODNER ANGELINA S PSYCHOLOGY S18084-4W 10/4/2013
RIEGER BRIAN PAUL PSYCHOLOGY S13107-8W 10/4/2013
LAINO JOSEPH PSYCHOLOGY S14829-6I 10/4/2013
KRELLMAN JASON WARREN PSYCHOLOGY S19043-9W 10/4/2013
HIRSHSON CHARI ILANA PSYCHOLOGY S19756-6B 10/4/2013
BARTOSZEK TAMMY ANNE REDHEAD PSYCHOLOGY S14920-3W 10/4/2013
CARONE DOMINIC A PSYCHOLOGY S16326-1W 10/4/2013
SMITH RICHARD M PSYCHOLOGY S05148-2W 10/4/2013
ROGERSON MARK DAVID PSYCHOLOGY S19256-7B 10/29/2013
COPANS TERRI LYNN PSYCHOLOGY S15108-4B 10/29/2013
TAYLOR JEROME D SURGERY 231485-4W 10/16/2013
FUEG ADRIENNE SURGERY 204001-2B 10/29/2013
SINGH PARAMJEET SURGERY 249409-4B 10/29/2013
WISEMAN JEFFREY SCOTT SURGERY, COLON/RECTAL SURGERY 190990-2W 10/30/2013
JAWA RANDEEP SINGH SURGERY, SURGICAL CRITICAL CARE 230785-8B 10/3/2013
ROTONDO MICHAEL FREDERICK SURGERY, SURGICAL CRITICAL CARE 270454-2W 10/9/2013

*Providers authorized to treat only, have an authorization number ending in “W” – Providers authorized to treat and perform independent medical examinations, have an authorization number ending in “B” – Providers authorized to perform independent medical examinations only, have an authorization number ending in “I”

The following doctors have been added to the list of Impartial Specialists eligible for appointment in specific cases by the Board.

NAME SPECIALTY AREA
OF PRACTICE
LICENSE
NUMBER
EFFECTIVE
DATE
END DATE
GEER DEBORAH ANN SURGERY 238625-8 10/2/2013 10/2/2018
HAMILL CHRISTOPHER LAWRENCE ORTHOPEDIC SURGERY 200675-7 10/2/2013 10/2/2018
ROOFEH JAHANSHAH ORTHOPEDIC SURGERY 144347-2 10/8/2013 10/8/2018
SLOUGH JAMES ALAN ORTHOPEDIC SURGERY 188540-9 10/8/2013 10/8/2018

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

Robert E. Beloten
Chair