Keaton Yaw

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

6417 E County Line Rd Ste 100
Tampa, FL 33647-1855

Phone

(813) 461-8840

NPI assigned

Jun 5, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optimal Performance and Physical Therapies Tyrone, LLCGroup PAC ID 6507299583, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Optimal Performance & Physical Therapies Tyrone, LLC

  • Physical Therapist
  • St Petersburg, FL
  • NPI 1356807531
  Medicare reassignment Care Compare group NPD
• Optimal Performance and Physical Therapies St. Petersburg, LLC

  • Physical Therapist
  • St Petersburg, FL
  • NPI 1073085734
  NPD (past)
• University Community Hospital, Inc

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1053321919
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1063253623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N HOWARD AVE UNIT 221",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336061077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6417 E COUNTY LINE RD STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336471855",
            "telephone_number": "813-461-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAW",
        "first_name": "KEATON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyson Yates
• Alyssa Yates, RMFTI
• Lauren N. Yates, P.A.-C
• Alexandra Yatros, MPAS, PA-C
• Michelle A. Yavelow, RD
• Adel Yazdankhahkenary, MD
• Ybor City Dialysis LLC
• Ybor City Elite Salon
• Ybor City SNF Operations LLC
• Ybor Medical Injury and Accident Clinic Inc

• Physical Therapist in Tampa, FL
• Providers in Tampa, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.