Individual provider Active NPI

Anthony P Rinaldi, PHD

  • Psychologist
  • Latham, NY
National Provider Identifier
1063906451
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3588-57 Issued in WI
Practice address
15 Cornell Rd
Latham, NY 12110-1491
Phone
(518) 510-3100
Fax
(608) 410-2905
NPI assigned
Jun 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3588-57 WI Primary

Addresses

Primary practice location

15 Cornell Rd
Latham, NY 12110-1491

Mailing address

76 Waverly Cir
Watervliet, NY 12189-1625
Phone (630) 779-5328

Other practice location 1

1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone (608) 252-8000

Other identifiers 1

IdentifierTypeStateIssuer
1063906451MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address arinaldi271941@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 7, 2022 through Dec 7, 2026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3588-57WIMDPsychologist
025010NYMDOccupational Therapist

Interoperability endpoints

  • Direct secure messaging: arinaldi271941@direct-ehr-ssmhc.com

NPI Registry JSON

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1063906451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 WAVERLY CIR",
            "city": "WATERVLIET",
            "state": "NY",
            "postal_code": "121891625",
            "telephone_number": "630-779-5328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CORNELL RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101491",
            "telephone_number": "518-510-3100",
            "fax_number": "608-410-2905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1211 Fish Hatchery Rd",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537151909",
            "country_code": "US",
            "telephone_number": "608-252-8000",
            "fax_number": "608-410-2905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RINALDI",
        "first_name": "ANTHONY",
        "middle_name": "P",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-19",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3588-57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063906451",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arinaldi271941@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "arinaldi271941@direct-ehr-ssmhc.com",
            "address_1": "1313 Fish Hatchery Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1313 Fish Hatchery Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.