INTERMEDIARY-CARRIER DIRECTORY U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PART A INTERMEDIARY AND PART B CARRIER BY STATE Part A - Empire HealthChoice Assurance, Inc. Part B - HealthNow New York, Inc. Empire HealthChoice Assurance,Inc. Group Health Incorporated RHHI – United Government Services, LLC DME MAC – National Heritage Insurance Company PART A INTERMEDIARIES AND PART B CARRIERS NEW YORK PART A PROVIDER SERVICE AREA: States of New York, Delaware, and Connecticut PART B JURISDICTION: Counties of Bronx, Columbia, Delaware, Duchess, Greene, Kings, Nassau, New York, Orange, Putnam, Richmond, Rockland, Suffolk, Sullivan, Ulster, Westchester and State of New Jersey. (Also - See HealthNow New York Inc. and Group Health Incorporated) EMPIRE HEALTHCHOICE ASSURANCE, INC.(d.b.a. Empire Medicare Services) PART A - AGREEMENT NO. HCFA 87-001-1.38 FAX: 914-248-2948 PART B - CONTRACT NO. HCFA 87-021-2 INTERNET: lloyd.kasow@empireblue.com Michael A. Stocker, M.D., President & CEO, 11 West 42 Street,New York, NY 10036 Gloria McCarthy, Executive Vice President & Chief Operating Officer, 11 West 42 Street, New York, NY 10036 Michael McCarron, Medicare Operations Officer, Christine Thomas, Assistant Vice President, Public Relations & Medicare Part A Operations, 400 South Salina Street, Syracuse, NY 13202. PHONE: 315-442-4530 Karen Turner, Director, Medicare Part B NY Operations, 2651 Strang Blvd., Yorktown Heights, NY 10598. PHONE: 914-248-3218 Steven C. Cline, Director, Medicare Part B New Jersey Operations, 300 East Park Drive, Harrisburg, PA 17111. PHONE: 717-565-3494 NEW YORK PART B JURISDICTION: The State of New York-Counties-Albany, Allegany, Broome, Cattaraugus, Cayuga, Chautauqua, Chenango, Chemung, Clinton, Cortland, Erie, Essex, Franklin, Fulton, Genesee, Hamilton, Herkimer, Jefferson, Lewis, Livingston, Madison, Monroe, Montgomery, Niagara, Oneida, Ontario, Onondaga, Orleans, Oswego, Otsego, Rensselaer, Saratoga, Schenectady, Schoharie, Schuyler, Seneca, Steuben, St. Lawrence, Tioga, Tompkins, Warren, Washington, Wayne, Wyoming, and Yates (except for the Counties served by Empire Health Choice, Inc. and Group Health, Inc.) HEALTHNOW NEW YORK, INC., 1901 Main Street, Buffalo, New York 14208 P.O. Box 80, Buffalo, New York 14240-0080 UPSTATE MEDICARE DIVISION HealthNow New York Inc., 33 Lewis Road, Binghamton, New York 13905 P.O. Box 5236, Binghamton, NY 13902-5236 PHONE: 716-887-6900 (Buffalo) PART B - CONTRACT NO. HCFA 87-022-2 FAX: 716-887-8548 (Buffalo) www.umd.nycpic.com James Dickerson, Ex. Vice President, Chief Financial Officer and Treasurer, PHONE: 716-887-2025 E-mail: Dickerson.James@Healthnow.org Mr. Dennis Gorski, Sr. Vice President, Government Programs, PHONE: 716-887-6027 E-mail: Gorski.dennis@Healthnow.org Alphonso O’Neil-White, President & Chief Executive, Officer PHONE: 716-887-8508 E-mail: O’Neil-White.Alphonso@Healthnow.org Upstate Medicare Division HealthNow New York Inc., 33 Lewis Rd., Binghamton, NY 13905 Phone: 607-766-6000 (UMD) Fax: 607-766-6395 (UMD) P.O. Box 5236, Binghamton, NY 13902-5236 Upstate Medicare Division Joli Juodaitis, Managing Director, Upstate Medicare Division PHONE: 607-766-6270 E-mail:Juodaitis.joli@healthnow.org DMERC (See Upstate Medicare Division) Joli Juodaitis, Managing Director, PHONE: 607-766-6325, FAX: 607-766-6395 Juodaitis.joli@healthnow.org GROUP HEALTH INCORPORATED, 25 Broadway, New York, New York 10004 PART B JURISDICTION: Queens County, New York PHONE: 646-458-6600 FAX: 646-458-6761 Peter S. Moore, Vice President, PHONE: 646-458-6601 Jim Brady, Director of Medicare Operations Program Evaluation and Integrity, PHONE: 646-458-6682, FAX: 646-458-6761 DURABLE MEDICAL EQUIPMENT MEDICARE ADMINISTRATIVE CONTRACTORS (DME MACs) AND REGIONAL HOME HEALTH INTERMEDIARIES Region V(*) United Government Services, LLC 401 West Michigan Street Milwaukee, Wisconsin 53203-2804 PHONE: 414-226-6203 Serving: Alaska, Arizona, California, Hawaii, Idaho, Oregon, Nevada, Washington, Northern Mariana Islands, Guam, and American Samoa, Michigan, Minnesota, New Jersey, New York, Puerto Rico, the Virgin Islands, and Wisconsin *Designates the CMS Region in which the intermediary is physically located. Durable Medical Equipment Medicare Administrative Contractors (DME MACs) A JURISDICTION National Heritage Insurance Company HHSM-500-2006-M0001Z Anne Bockhoff Dalton Vice President 75 Sgt. William Terry Drive Hingham, MA 02043 PHONE: 781-741-3201 FAX: 781-741-3582 Serving: Connecticut, Delaware, District of Columbia, Maine, Massachusetts, Maryland, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont