Individual provider Active NPI

Tysharra Belfon, MSN FNP-BC

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1477087104
Registry record updated May 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11007316 Issued in FL
Practice address
16400 NW 2ND Ave Ste 100
Miami, FL 33169-6035
Phone
(305) 948-4701
NPI assigned
Apr 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9360419 FL
Family Nurse Practitioner 363LF0000X 11007316 FL Primary

Addresses

Primary practice location

16400 NW 2ND Ave Ste 100
Miami, FL 33169-6035

Mailing address

1861 SW 101St Way
Miramar, FL 33025-6531
Phone (786) 412-1150

Other practice location 1

1600 Sarno Rd
Suite 15
Melbourne, FL 32935-4938
Phone (615) 345-5400

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
I20210728000509 FL Practitioner - Nurse Practitioner 7517360530

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN9360419FLMDRegistered Nurse
11007316FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Primary Healthcare CurrentSince Nov 18, 2024 Accepting new patients

Locations

8053 W Oakland Park Blvd
Ste 600
Sunrise, FL 33351
Phone (786) 412-1150

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": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590796800000",
    "number": "1477087104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1861 SW 101ST WAY",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330256531",
            "telephone_number": "786-412-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16400 NW 2ND AVE STE 100",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331696035",
            "telephone_number": "305-948-4701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Sarno Rd",
            "address_2": "Suite 15",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329354938",
            "country_code": "US",
            "telephone_number": "615-345-5400",
            "fax_number": "888-468-6511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELFON",
        "first_name": "TYSHARRA",
        "name_prefix": "Mrs.",
        "credential": "MSN FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-19",
        "last_updated": "2020-05-30",
        "certification_date": "2020-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9360419",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11007316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.