Kruawan - Paksaichol, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

135912 Issued in NY

Practice address

123 Pennsylvania Ave
Brooklyn, NY 11207-2428

Phone

(718) 922-3765

Fax

(718) 922-3765

NPI assigned

Aug 15, 2005

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 1970

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417949686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25555 149TH AVE",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222812",
            "telephone_number": "718-712-2849",
            "fax_number": "718-922-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 PENNSYLVANIA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112072428",
            "telephone_number": "718-922-3765",
            "fax_number": "718-922-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAKSAICHOL",
        "first_name": "KRUAWAN",
        "middle_name": "-",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "135912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00427610",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pakam Pharmacy Inc
• Nisim Pakanaev, RN
• Meltem Paker, PH.D,, LP, RPT-S
• Zhanna Pakhomova, MS ED
• Sanjaikrishna Pakkirisamy Kannan, M.B.B.S.
• Rohit Pal, DO
• Pala Community Care LLC
• Mordechai Palace
• Lynette M Palacio, CASAC
• Ruti Palacio

• Internal Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.