Individual provider Active NPI

Tysam Chadli Beckett, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Clermont, FL
National Provider Identifier
1114349735
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11014430 Issued in FL
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

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210913001115 FL Practitioner - Nurse Practitioner 4789080078 Reassigns benefits to 1 organization

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
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

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

LicenseStateTypeSpecialty
RN9368798FLMDPsychiatric/Mental Health Registered Nurse
APRN11014430FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Oct 18, 2021 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.