NPIMap

Organization Active NPI

Shoprite Supermarkets, Inc

Doing business as Shoprite Pharmacy of Monticello

  • Community/Retail Pharmacy
  • Monticello, NY
National Provider Identifier
1508971383
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SHOPRITE SUPERMARKETS, INC
Doing business as
Shoprite Pharmacy of Monticello
Practice address
4440 State Route 42
Monticello, NY 12701-4844
Phone
(845) 794-0237
Fax
(845) 794-0257
NPI assigned
Aug 20, 2006
Last updated
Jun 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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 025415 NY
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

4440 State Route 42
Monticello, NY 12701-4844

Mailing address

Post Ofc
PO Box 29010
New York, NY 10087-9010

Other identifiers 2

IdentifierTypeStateIssuer
02060855MedicaidNY
3325948OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • SHOPRITE PHARMACY OF MONTICELLO Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930087394 NY DME Supplier - PharmacyDME Supplier - Grocery Store 9436278413 Practice locations: Monticello, NY
O20110110000400 NY Part B Supplier - Mass Immunization (Roster Biller Only) 9436278413 15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Carmel, NY; Hudson, NY; Monticello, NY

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Shoprite Pharmacy8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

709 Central Ave
Albany, NY 12206
Phone (518) 243-4568

178 Route 52
Carmel, NY 10512
Phone (845) 225-1038

801 Miron Ln
Kingston, NY 12401
Phone (845) 336-7833

20 Lloyds Ln
Middletown, NY 10940
Phone (845) 341-2104

3140 E Main St
Mohegan Lake, NY 10547
Phone (914) 739-7474

4440 Rte 42
Monticello, NY 12701
Phone (845) 794-0237

4440 State Rte 42
Monticello, NY 12701
Phone (845) 794-0237

46 Thompson Sq
Monticello, NY 12701
Phone (845) 794-0237

46 Thompson Square Mall
Monticello, NY 12701
Phone (845) 794-0237

1895 South Rd
Poughkeepsie, NY 12601
Phone (845) 298-0097

41 Vista Blvd
Slingerlands, NY 12159
Phone (518) 813-4543

Practitioners & affiliated clinicians

Practitioners 30

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 30

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": "1307318400000",
    "number": "1508971383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POST OFC",
            "address_2": "PO BOX 29010",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100879010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 STATE ROUTE 42",
            "city": "MONTICELLO",
            "state": "NY",
            "postal_code": "127014844",
            "telephone_number": "845-794-0237",
            "fax_number": "845-794-0257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPRITE SUPERMARKETS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2011-06-06",
        "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": "NY",
            "license": "025415",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02060855",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3325948",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHOPRITE PHARMACY OF MONTICELLO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monticello, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; 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.