NPIMap

Organization Active NPI

Inserra Supermarket Inc

Doing business as ShopRite Pharmacy of Lodi

  • Pharmacy
  • Lodi, NJ
National Provider Identifier
1790823706
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
RS003702 Issued in NJ
Legal business name
INSERRA SUPERMARKET INC
Doing business as
ShopRite Pharmacy of Lodi
Practice address
175 Main Street
Lodi, NJ 07644
Phone
(973) 365-2289
Fax
(973) 365-0925
NPI assigned
Feb 2, 2007
Last updated
Aug 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X RS003702 NJ Primary

Addresses

Primary practice location

175 Main Street
Lodi, NJ 07644

Mailing address

PO Box 21158
New York, NY 10087-1158
Phone (973) 365-2289

Other identifiers 3

IdentifierTypeStateIssuer
4366310OtherNJMEDICAID DME
3127241OtherNJNCPDP
4366301MedicaidNJ

Other names 1

  • ShopRite Pharmacy of Lodi 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
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 1

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1790823706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21158",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100871158",
            "telephone_number": "973-365-2289",
            "fax_number": "973-365-0925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MAIN STREET",
            "city": "LODI",
            "state": "NJ",
            "postal_code": "07644",
            "telephone_number": "973-365-2289",
            "fax_number": "973-365-0925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSERRA SUPERMARKET INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "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": "RS003702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "4366310",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3127241",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4366301",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ShopRite Pharmacy of Lodi",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lodi, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; 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.