YOUR PRIMARY CARE PROVIDER LISTING - EmblemHealth

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Introduction This listing provides primary care physicians in HIP’s Select Network. To get detailed information about your health care coverage, please see your Evidence of Coverage. You will have to choose one of our plan providers that are provided in this listing to be your Primary Care {Physician/Provider} (PCP). The term “PCP” will be used throughout this listing. Generally, you must get your health care coverage from your PCP. Your PCP is your primary care physician, who can provide and coordinate all of your care, including specialist visits, hospital admissions and more. The “plan providers” in this network have agreed to provide you with your health care coverage. If you have been going to one plan provider, you are not required to continue going to that same provider. In some cases, you may get covered services from non-plan providers. Please check your Evidence of Coverage for more details on specific referral requirements and more details about your plan benefits. What is the service area for HIP Select Network? The counties in our service area are listed below. Bronx, Brooklyn, Manhattan, Nassau, Queens, Rockland, Staten Island, Suffolk and Westchester Counties How do you find HIP Select Network providers in your area? You can find a provider by looking in this listing or going online at www.hipusa.com. We do everything possible to keep our materials current, but participation status can change from time to time. Before selecting your PCP, you may want to confirm that he or she is still participating in the HIP network and with the product you are covered by, and if they are accepting new patients. You can do this by contacting the provider at the phone number provided in the listing. If you have questions about HIP Select Network, please call our Customer Service Department at 1-800-447-8255, 8:00 am to 8:00 pm, daily, if you have a hearing or speech impairment and use a TDD, please call 1-888-447-4833, Monday through Friday, from 8:30 am to 5:00 pm. ii
Provider Listing Key To find the full name of any participating hospital shown under the physician listing contained in this listing, please refer to the Hospital Abbreviation Key. Provider’s name Provider’s ID number (PRIS)*/provider’s gender 1 DIRECTORY KEY Doe, John, MD 01234P Not accepting new patients Primary Medical Care Denotes board certification** Provider’s status on accepting new patients 3 Specialty/Office name 2 123 Main Street Pleasantville, NY 12345 Office street address 1 Office phone number (555) 555-5555 or the clinical staff 1 Hospital affiliations 1 Hospital Codes: LUTH, MAIM see hospital Languages spoken abbreviation key by the practitioner and/ Languages: Italian * The Provider PRIS number is an office location-specific number that a provider uses, along with a Personal Identification Number (PIN) to access HIP’s Interactive Voice Response (IVR) System and HIP’s Web site at hipusa.com. ** Practitioners must satisfy the requirements/standards of a nationally recognized specialty board and receive specialist certification from either ABMS or AOA. Board certification is verified by ABMS and AOA during the re-credentialing process every three years. 1 Information is collected from the Provider Application; therefore, it is self-reported and is validated every three years during the re-credentialing process or sooner based on provider notification. 2 Information is collected from the Provider Application and validated every three years during the re-credentialing process. For Board Certified Providers, information is collected from and verified by ABMS or AOA. For Non-Board Certified Providers, information is verified from the highest level of training and with the Licensing Board. 3 Acceptance of new patients applies to primary care physicians. Unless otherwise noted, all physicians are accepting new patients. iii
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KINGS PRIMARY CARE PHYSICIANS Kings
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SUFFOLK PRIMARY CARE PHYSICIANS Suf
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WESTCHESTER PRIMARY CARE PHYSICIANS
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INDEX BY LAST NAME
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INDEX BY LAST NAME Batheja, Roma M,
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INDEX BY LAST NAME Elliott, Charmai
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INDEX BY LAST NAME Jao, Superio, MD
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INDEX BY LAST NAME May, Helen E, MD
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INDEX BY LAST NAME Rameau, Jean E,
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INDEX BY LAST NAME Tessler, Herman,
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55 Water Street, New York, New York
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YOUR PRIMARY CARE PROVIDER LISTING - EmblemHealth

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