Active NPI
Inserra Supermarket Incorporated
- Pharmacy
- Hillsdale, NJ
National Provider Identifier
1497860274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- RS003297
- Legal business name
- INSERRA SUPERMARKET INCORPORATED
- Practice address
- 372 Broadway
Hillsdale, NJ 07642 - Phone
- (201) 664-0556
- Fax
- (201) 664-8152
- NPI assigned
- Aug 20, 2006
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | RS003297 | NJ | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
372 Broadway
Hillsdale, NJ 07642
Mailing address
PO Box 8500-51250
Philadelphia, PA 19178-0001
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4341112 | Other | NJ | MEDICAID DME |
| 4341104 | Medicaid | NJ | |
| 3124548 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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.
-
- Community/Retail Pharmacy
- Hoboken, NJ
- NPI 1477691244
O20111013000093
-
- Community/Retail Pharmacy
- Lyndhurst, NJ
- NPI 1750496535
O20111013000093
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
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": "1347321600000",
"number": "1497860274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8500-51250",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191780001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "372 BROADWAY",
"city": "HILLSDALE",
"state": "NJ",
"postal_code": "07642",
"telephone_number": "201-664-0556",
"fax_number": "201-664-8152"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INSERRA SUPERMARKET INCORPORATED",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-20",
"last_updated": "2012-09-11",
"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": "RS003297",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID DME",
"identifier": "4341112",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4341104",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3124548",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Hillsdale, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; 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.