Individual provider Active NPI

Manraj S Kaeley, PHARMD

  • Pharmacist
  • Vacaville, CA
National Provider Identifier
1851655807
Registry record updated Jun 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
57724 Issued in CA
Practice address
2100 Peabody Rd
Vacaville, CA 95687-6639
Phone
(707) 451-0182
NPI assigned
Jun 25, 2012
Last updated
Jun 25, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 57724 CA Primary

Addresses

Primary practice location

2100 Peabody Rd
Vacaville, CA 95687-6639

Mailing address

4192 Anatolia Dr
Rancho Cordova, CA 95742-8038
Phone (209) 535-6601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Corrections and Rehabilitation-Headquarters PastSince Apr 26, 2020 Accepting new patients
State of California Prison Industry Authority Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340582400000",
    "number": "1851655807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4192 ANATOLIA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "957428038",
            "telephone_number": "209-535-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 PEABODY RD",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956876639",
            "telephone_number": "707-451-0182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAELEY",
        "first_name": "MANRAJ",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-25",
        "last_updated": "2012-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "57724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vacaville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; 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.