NPIMap

Organization Active NPI

Inserra Supermarkets Inc

Doing business as Shoprite Pharmacy

  • Community/Retail Pharmacy
  • Wallington, NJ
National Provider Identifier
1194830976
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
INSERRA SUPERMARKETS INC
Doing business as
Shoprite Pharmacy
Practice address
375 Paterson Ave
Wallington, NJ 07057-2101
Phone
(973) 471-7575
Fax
(973) 471-2198
NPI assigned
Aug 20, 2006
Last updated
Dec 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Authorized official

Name
Melissa Figueroa Rivera
Title
Third Party Administrator
Phone
(732) 521-8439

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X RS004991 NJ
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

375 Paterson Ave
Wallington, NJ 07057-2101

Mailing address

PO Box 781250
Philadelphia, PA 19178-1250

Other identifiers 3

IdentifierTypeStateIssuer
3135894OtherOTHER ID NUMBER-COMMERCIAL NUMBER
0252395MedicaidNJ
0252689OtherNJMEDICAID DME

Other names 1

  • Shoprite Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111013000093 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 9436276185 10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Emerson, NJ; Hillsdale, NJ; Hoboken, NJ; Jersey City, NJ; Lodi, NJ; Lyndhurst, NJ; New Milford, NJ; Northvale, NJ…

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

380 Broadway
Hillsdale, NJ 07642
Phone (201) 664-0556

900 Madison St
Hoboken, NJ 07030
Phone (201) 792-9652

400 Marin Blvd
Jersey City, NJ 07302
Phone (201) 418-0327

175 Main St
Lodi, NJ 07644
Phone (973) 365-2289

540 New York Ave
Lyndhurst, NJ 07071
Phone (201) 933-4782

250 River Rd
New Milford, NJ 07646
Phone (201) 262-8838

246 Livingston St
Northvale, NJ 07647
Phone (201) 641-4998

641 Hamburg Tpke
Wayne, NJ 07470
Phone (973) 595-0296

23 Marshall Hill Rd
West Milford, NJ 07480
Phone (973) 728-4754

56 W Ramapo Rd
Garnerville, NY 10923
Phone (845) 786-3402

66 N Main St
New City, NY 10956
Phone (845) 429-0905

22 Holt Dr
Stony Point, NY 10980
Phone (732) 521-8439

243 Route 59
West Nyack, NY 10994
Phone (845) 353-4949

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449532800000",
    "number": "1194830976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781250",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191781250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 PATERSON AVE",
            "city": "WALLINGTON",
            "state": "NJ",
            "postal_code": "070572101",
            "telephone_number": "973-471-7575",
            "fax_number": "973-471-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSERRA SUPERMARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2015-12-08",
        "status": "A",
        "authorized_official_last_name": "FIGUEROA RIVERA",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "THIRD PARTY ADMINISTRATOR",
        "authorized_official_telephone_number": "732-521-8439"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "RS004991",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3135894",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0252395",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "0252689",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoprite Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wallington, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.