NPIMap

Organization Active NPI

Shoprite Supermarkets, Inc

Doing business as Shoprite Pharmacy of Niskayuna

  • Community/Retail Pharmacy
  • Niskayuna, NY
National Provider Identifier
1851679989
Registry record updated Apr 9, 2012
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 Niskayuna
Practice address
2333 Nott St E
Niskayuna, NY 12309-4302
Phone
(518) 243-4568
Fax
(518) 243-4570
NPI assigned
Jul 22, 2011
Last updated
Apr 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

2333 Nott St E
Niskayuna, NY 12309-4302

Mailing address

PO Box 29010
New York, NY 10087-9010

Other identifiers 1

IdentifierTypeStateIssuer
5803451OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Shoprite Pharmacy of Niskayuna Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110110000400 NY Part B Supplier - Mass Immunization (Roster Biller Only) 9436278413 15 other NPIs on this 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

Locations

2333 Nott St E
Schenectady, NY 12309
Phone (518) 243-4567

Practitioners & affiliated clinicians

Practitioners 3

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": "1311292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333929600000",
    "number": "1851679989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "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": "2333 NOTT ST E",
            "city": "NISKAYUNA",
            "state": "NY",
            "postal_code": "123094302",
            "telephone_number": "518-243-4568",
            "fax_number": "518-243-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPRITE SUPERMARKETS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-22",
        "last_updated": "2012-04-09",
        "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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5803451",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoprite Pharmacy of Niskayuna",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Niskayuna, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.

Verify at the official NPI Registry.