Nanwai Pak, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

172780 Issued in NY

Practice address

150 55TH St
Station 3-06
Brooklyn, NY 11220-2559

Phone

(718) 630-6384

Fax

(718) 630-7604

NPI assigned

Oct 12, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: npak113785@nyumc.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St Vincents Hospital and Medical Center

  • Specialist
  • New York, NY
  • NPI 1285746354
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1396733531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 55TH ST",
            "address_2": "STATION 3-06",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202559",
            "telephone_number": "718-630-6384",
            "fax_number": "718-630-7604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 55TH ST",
            "address_2": "STATION 3-06",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202559",
            "telephone_number": "718-630-6384",
            "fax_number": "718-630-7604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAK",
        "first_name": "NANWAI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "172780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0051080",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02862059",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "npak113785@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "150 55th St",
            "address_2": "Station 3-06",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112202559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Augusto D Paiusco, M.D.
• Shalyni Paiyappilly
• Dwayne Dave Vincent Cuay Pajaron
• Pak Hong Sik MD Medical Care PC
• Pak Pharmacy Inc.
• Sean Pak
• Vivian Pak, DDS
• Vongku Pak
• Pakam Pharmacy Inc
• Nisim Pakanaev, RN

• Physical Medicine & Rehabilitation Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.