Subject Numbers Regarding Health Provider Authorizations

Authorization No. 147885-8B

June 2, 2025

Please be advised that Dr. Richard Semble (hereinafter, "the provider") has resigned their authorization to perform independent medical examinations in the New York State workers' compensation system effective June 1, 2025. The provider remains authorized to treat injured workers. The provider's last known practice address is:

Montefiore Medical Center
408 Airport Executive Park
Nanuet, New York 10954

The provider is prohibited from performing independent medical examinations of injured workers and from conducting reviews of records regarding variance requests pursuant to 12 New York Codes, Rules and Regulations § 324.3(b)(2)(ii)(a). Reports submitted by the provider for services rendered prior to June 1, 2025, are valid but are invalid for any services rendered on or after that date. Requests to cross-examine the provider for services rendered prior to June 1, 2025, should not be denied due to their resignation.

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