Subject Numbers Regarding Health Provider Authorizations

Authorization No. 224024-0W

May 27, 2014

Please be advised that Dr. Jason Shevetz has resigned his authorization to treat injured workers in the New York State workers' compensation system effective May 23, 2014. Dr. Shevetz's last known practice address is 255 East 98th Street, Brooklyn, NY 11212.

Dr. Shevetz is prohibited from rendering treatment and care to injured workers. Reports submitted by Dr. Shevetz for services rendered prior to May 23, 2014 are valid, but are invalid for any services rendered on or after that date. Requests to cross-examine Dr. Shevetz for services rendered prior to May 23, 2014 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.