Individual provider Active NPI

Christian Hietanen, D.O.

  • Pediatrics Physician
  • Poughkeepsie, NY
National Provider Identifier
1558322958
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
235451 Issued in NY
Practice address
1 Webster Ave
Suite 302
Poughkeepsie, NY 12601-1361
Phone
(845) 483-5852
Fax
(845) 483-5413
NPI assigned
Mar 28, 2006
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 235451 NY Primary

Addresses

Primary practice location

1 Webster Ave
Suite 302
Poughkeepsie, NY 12601-1361

Mailing address

1 Webster Ave Ste 302
Poughkeepsie, NY 12601-1362
Phone (845) 483-5852

Other practice location 1

301 Manchester Rd Ste 105
Poughkeepsie, NY 12603-2587
Phone (845) 452-1700

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221222001449 NY Practitioner - Pediatric Medicine 7911377502 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
235451NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Group of the Hudson Valley P.C. Pediatrics CurrentSince Dec 1, 2022 Accepting new patients
Premier Medical Group of the Hudson Valley, P.C. CurrentSince Dec 1, 2022 Accepting new patients
Boston Children's Health Physicians, LLP Pediatrics CurrentSince Jul 6, 2024 Accepting new patients
Boston Childrens Health Physicians LLP CurrentSince Jul 6, 2024 Accepting new patients
The Children's Medical Group PLLC Pediatrics PastSince May 10, 2020 Accepting new patients
The Children's Medical Group PLLC Pediatrics Past Accepting new patients
The Children's Medical Group PLLC Pediatrics Past Accepting new patients
The Childrens Medical Group Pediatrics Past Accepting new patients

Locations

200 Westage Business Ctr Dr
Ste 111
Fishkill, NY 12524
Phone (845) 896-4505

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

1 Webster Ave
Ste 302
Poughkeepsie, NY 12601
Phone (845) 454-4200

243 North Rd
Ste 304
Poughkeepsie, NY 12601
Phone (845) 451-7251

Networks

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

Interoperability endpoints

  • Direct secure messaging: chietanen@premiermedicalhv.medentdirect.com
  • Direct secure messaging: christian.hietanen.p1@direct.cwpw.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1558322958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WEBSTER AVE STE 302",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011362",
            "telephone_number": "845-483-5852",
            "fax_number": "845-483-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WEBSTER AVE",
            "address_2": "SUITE 302",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011361",
            "telephone_number": "845-483-5852",
            "fax_number": "845-483-5413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Manchester Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Poughkeepsie",
            "state": "NY",
            "postal_code": "126032587",
            "country_code": "US",
            "telephone_number": "845-452-1700",
            "fax_number": "845-452-1752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIETANEN",
        "first_name": "CHRISTIAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "235451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.