NPIMap

Organization Active NPI

Inserra Supermarket Inc

  • Pharmacy
  • West Nyack, NY
National Provider Identifier
1952416737
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
019616 Issued in NY
Legal business name
INSERRA SUPERMARKET INC
Practice address
243 Route 59
West Nyack, NY 10994-2036
Phone
(845) 353-4949
Fax
(845) 353-3993
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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 019616 NY Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

243 Route 59
West Nyack, NY 10994-2036

Mailing address

PO Box 21158
New York, NY 10087-1158
Phone (845) 353-4949

Other identifiers 2

IdentifierTypeStateIssuer
01056862MedicaidNY
3390919OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • Shoprite Pharmacy Doing business as

National Provider Directory

National Provider Directory

Member of 1

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

Locations

243 Route 59
West Nyack, NY 10994
Phone (845) 353-4949

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1494460800000",
    "number": "1952416737",
    "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": "845-353-4949",
            "fax_number": "845-353-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 ROUTE 59",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109942036",
            "telephone_number": "845-353-4949",
            "fax_number": "845-353-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSERRA SUPERMARKET INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2017-05-11",
        "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": "NY",
            "license": "019616",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01056862",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3390919",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoprite Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Nyack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.