BEACON PRIMARY CARE LLC
NPI 1184384349
Family Medicine in Lutz, FL
About Beacon Primary Care Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BEACON PRIMARY CARE LLC (NPI 1184384349) is a healthcare organization registered as a family medicine in Lutz, Florida and active in the NPI registry since December 2021. The organization lists Tyler Penrod, Biller, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Beacon Primary Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Beacon Primary Care LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Beacon Primary Care LLC's NPI number?
The NPI number for Beacon Primary Care LLC is 1184384349. It was assigned to this organization in the NPPES registry on December 29, 2021.
Where is Beacon Primary Care LLC located?
Beacon Primary Care LLC is located at 17819 Tidewater Bay Ln, Lutz, FL 33549. The listed phone number is (813) 447-9249.
What is Beacon Primary Care LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Beacon Primary Care LLC enrolled in Medicare?
Yes. Beacon Primary Care LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Beacon Primary Care LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Beacon Primary Care LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Beacon Primary Care LLC was last updated on December 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Beacon Primary Care Llc · NPI 1184384349
Family Medicine organization in Lutz, Florida. Organization record, active in the CMS NPPES registry since December 29, 2021.
## Identity
- **NPI:** 1184384349 (Entity type: Organization)
- **Enumerated:** December 29, 2021
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Tyler Penrod, BILLER
## Practice location
- **Address:** 17819 TIDEWATER BAY LN, Lutz, FL 33549-5419
- **Phone:** (813) 447-9249
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 29, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1184384349) · Data from the CMS NPPES public registry.