Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Keaton Yaw

Individual provider Physical Therapist · NPI 1063253623

Keaton Yaw is a Physical Therapist in Private Practice in Tampa, Florida. Qualified in 2023, 3 years ago. Practices with Optimal Performance and Physical Therapies Tyrone, LLC, a 4-clinician group and accepts Medicare assignment.

Years since qualifying
3
In the registry since
2024
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Practice location Address checks out

6417 E County Line Rd Ste 100
Tampa, FL 33647-1855
Phone: (813) 461-8840
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1063253623
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 5, 2024
Last updated in NPPESJune 5, 2024
Certification dateJune 5, 2024
Mailing address800 N Howard Ave Unit 221, Tampa, FL 33606-1077

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Optimal Performance And Physical Therapies Tyrone, Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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