Basic Information
Provider Information
NPI: 1023075165
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RINALDI
FirstName: JAMES
MiddleName: J
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 199 PARK CLUB LN STE 300
Address2:  
City: WILLIAMSVILLE
State: NY
PostalCode: 142215269
CountryCode: US
TelephoneNumber: 7168364646
FaxNumber: 7168364696
Practice Location
Address1: 199 PARK CLUB LN STE 300
Address2:  
City: WILLIAMSVILLE
State: NY
PostalCode: 142215269
CountryCode: US
TelephoneNumber: 7168364646
FaxNumber: 7168364696
Other Information
ProviderEnumerationDate: 05/01/2006
LastUpdateDate: 12/17/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/17/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X232173NYY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
0002687850501 UNIVERAOTHER
04081000010501 FIDELISOTHER
00052771200101 BLUE SHIELD WNYOTHER
00052771200901 BLUE SHIELD WNYOTHER
P04023217301 BLUE SHIELD ROCHESTEROTHER
P0013403201 RR MEDICAREOTHER
014286301 GHIOTHER
419403001 GHIOTHER
P0014475001 RR MEDICAREOTHER
P01023217301 BLUE CHOICEOTHER
P02023217301 BLUE SHIELD ROCHESTEROTHER
0002687850701 UNIVERAOTHER
00052771200701 BLUE SHIELD WNYOTHER
195342FF01 PREFERRED CAREOTHER
2321735B01NYWORKERS COMPENSATIONOTHER
0002687850201 UNIVERAOTHER
0255856505NY MEDICAID
161254901 INDEPENDENT HEALTHOTHER


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