NPIMap

Individual provider Active NPI

Paul K Pietrow, MD

  • Urology Physician
  • Kingston, NY
National Provider Identifier
1982709945
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2358511 Issued in NY
Practice address
111 Marys Ave
Kingston, NY 12401
Phone
(845) 437-5000
Fax
(845) 339-4941
NPI assigned
Sep 14, 2006
Last updated
Sep 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2358511 NY Primary

Addresses

Primary practice location

111 Marys Ave
Kingston, NY 12401

Mailing address

243 North Rd
Suite 304
Poughkeepsie, NY 12601-1172
Phone (845) 437-5000

Other practice location 1

50 Eastdale Ave N
Poughkeepsie, NY 12603
Phone (845) 437-5000

Other identifiers 1

IdentifierTypeStateIssuer
02741651MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070424000566 NY Practitioner - Urology 5193828499 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Virginia School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Columbia Memorial HospitalGroup PAC ID 5092709410, 171 clinicians

Practice addresses (Care Compare)

243 N Rd
Poughkeepsie, NY 12601-1173

2827 US Route 9
Valatie, NY 12184-0785
Phone (518) 828-8051

50 Eastdale Ave N
Poughkeepsie, NY 12603-1694
Phone (845) 437-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2358511NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Group of the Hudson Valley, P.C. CurrentSince Sep 1, 2005 Accepting new patients
Columbia Memorial Hospital CurrentSince Feb 1, 2026 Accepting new patients
Columbia Memorial Hospital CurrentSince Feb 1, 2026 Accepting new patients
Premier Medical Group of the Hudson Valley P.C. Urology CurrentSince Sep 1, 2005 Accepting new patients

Locations

71 Prospect Ave
Hudson, NY 12534
Phone (518) 262-3773

111 Marys Ave
Kingston, NY 12401
Phone (845) 339-4900

111 Marys Ave
Ste 3
Kingston, NY 12401

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

50 Eastdale Ave N
Poughkeepsie, NY 12603
Phone (845) 437-5000

2827 US Highway 9
Valatie, NY 12184
Phone (518) 828-7601

Networks

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

Interoperability endpoints

  • Direct secure messaging: ppietrow@premiermedicalhv.medentdirect.com

Organizations & group practices 5

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1982709945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 NORTH RD",
            "address_2": "SUITE 304",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011172",
            "telephone_number": "845-437-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MARYS AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "12401",
            "telephone_number": "845-437-5000",
            "fax_number": "845-339-4941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Eastdale Ave N",
            "address_purpose": "LOCATION",
            "city": "Poughkeepsie",
            "state": "NY",
            "postal_code": "12603",
            "country_code": "US",
            "telephone_number": "845-437-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIETROW",
        "first_name": "PAUL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "2358511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02741651",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.