NPIMap

Organization Active NPI

Inserra Supermarkets Inc.

  • Community/Retail Pharmacy
  • Jersey City, NJ
National Provider Identifier
1821103607
Registry record updated Feb 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
INSERRA SUPERMARKETS INC.
Practice address
400 Marin Blvd
Jersey City, NJ 07302-2546
Phone
(201) 418-0327
Fax
(201) 418-7370
NPI assigned
Aug 20, 2006
Last updated
Feb 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 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 RS005109 NJ
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

400 Marin Blvd
Jersey City, NJ 07302-2546

Mailing address

400 Marin Blvd
Jersey City, NJ 07302-2546

Other identifiers 3

IdentifierTypeStateIssuer
0252697OtherNJMEDICAID DME
3136670OtherOTHER ID NUMBER-COMMERCIAL NUMBER
0252409MedicaidNJ

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 1

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297814400000",
    "number": "1821103607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MARIN BLVD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073022546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MARIN BLVD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073022546",
            "telephone_number": "201-418-0327",
            "fax_number": "201-418-7370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSERRA SUPERMARKETS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2011-02-16",
        "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": "RS005109",
            "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": "MEDICAID DME",
            "identifier": "0252697",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3136670",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0252409",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.