Individual provider Active NPI

Colleen Maciel, NP

  • Family Nurse Practitioner
  • Oceanside, CA
National Provider Identifier
1104777200
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95031099 Issued in CA
Practice address
2424 Vista Way Ste 105
Oceanside, CA 92054-6178
Phone
(858) 209-3717
NPI assigned
Feb 4, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95031099 CA Primary

Addresses

Primary practice location

2424 Vista Way Ste 105
Oceanside, CA 92054-6178

Mailing address

441 Calle Corazon
Oceanside, CA 92057-8511

Other practice location 1

441 Calle Corazon
Oceanside, CA 92057-8511
Phone (760) 496-8999

Other names 1

  • Colleen Duckworth Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2424 Vista Way
Suite 105
Oceanside, CA 92054-6178

441 Calle Corazon
Oceanside, CA 92057-8511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95031099CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Senior Group CurrentSince May 19, 2026 Accepting new patients

Locations

2424 Vista Way
Ste 105
Oceanside, CA 92054
Phone (858) 209-3717

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1770163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1104777200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 CALLE CORAZON",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920578511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 VISTA WAY STE 105",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546178",
            "telephone_number": "858-209-3717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "441 Calle Corazon",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "920578511",
            "country_code": "US",
            "telephone_number": "760-496-8999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACIEL",
        "first_name": "COLLEEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-04",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95031099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "DUCKWORTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.