Active NPI
Anthony P Rinaldi, PHD
- Psychologist
- Latham, NY
National Provider Identifier
1063906451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3588-57
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063906451 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 3588-57 | WI | MD | Psychologist |
| 025010 | NY | MD | Occupational Therapist |
Interoperability endpoints
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.