Active NPI
Tysam Chadli Beckett, APRN, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Clermont, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- APRN11014430
- Practice address
- 17011 State Road 50 Ste 301
Clermont, FL 34711-8203 - Phone
- (833) 769-3524
- NPI assigned
- Jan 16, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APRN11014430 | FL | Primary |
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | RN9368798 | FL |
Addresses
Primary practice location
17011 State Road 50 Ste 301
Clermont, FL 34711-8203
Mailing address
17011 State Road 50 Ste 301
Clermont, FL 34711-8203
Phone (833) 769-3524
Other practice location 1
10821 Foxhole Rd
Clermont, FL 34711-8013
Phone (407) 408-4433
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
17011 State Rd
50 Suite 301
Clermont, FL 34711-8203
Phone (352) 833-6300
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN9368798 | FL | MD | Psychiatric/Mental Health Registered Nurse |
| APRN11014430 | FL | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Personal Recovery Network LLC | Current | Accepting new patients | |
| Aspire Health Partners, Inc. | Past | Accepting new patients |
Locations
17011 State Road 50
Ste 301
Clermont, FL 34711
Phone (352) 833-6300
8570 Granite Ct
Ste 101
Fort Myers, FL 33908
Phone (239) 310-4646
260 Lookout Pl
Ste 202
Maitland, FL 32751
Phone (407) 537-9450
250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685
Interoperability endpoints
- fbh.tysambeckett@141363.advancedmd-direct.com
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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Orlando, FL
- NPI 1821033903
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766016000000",
"number": "1114349735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17011 STATE ROAD 50 STE 301",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347118203",
"telephone_number": "833-769-3524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17011 STATE ROAD 50 STE 301",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347118203",
"telephone_number": "833-769-3524"
}
],
"practiceLocations": [
{
"address_1": "10821 Foxhole Rd",
"address_purpose": "LOCATION",
"city": "Clermont",
"state": "FL",
"postal_code": "347118013",
"country_code": "US",
"telephone_number": "407-408-4433",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BECKETT",
"first_name": "TYSAM",
"middle_name": "CHADLI",
"credential": "APRN, PMHNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-16",
"last_updated": "2025-12-18",
"certification_date": "2025-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "FL",
"license": "APRN11014430",
"primary": true
},
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "FL",
"license": "RN9368798",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clermont, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.