Individual provider Active NPI

Kenneth Fredrick Martin II, PT, DPT

  • Physical Therapist
  • Henderson, NV
National Provider Identifier
1154887511
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3960 Issued in NV
Practice address
9005 S Pecos Rd Ste 2520
Henderson, NV 89074-7191
Phone
(702) 818-5000
NPI assigned
Feb 11, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3960 NV Primary

Addresses

Primary practice location

9005 S Pecos Rd Ste 2520
Henderson, NV 89074-7191

Mailing address

9070 W Cheyenne Ave Ste 100
Las Vegas, NV 89129-8935
Phone (702) 818-5000

Other practice location 1

1590 W Sunset Rd Ste 110
Henderson, NV 89014-6633
Phone (702) 818-5000

Other practice location 2

401 N Buffalo Dr Ste 120
Las Vegas, NV 89145-0397
Phone (702) 818-5000

Other practice location 3

9070 W Cheyenne Ave Ste 100
Las Vegas, NV 89129-8935
Phone (702) 818-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190416002509 NV Practitioner - Physical Therapist in Private Practice 8729329982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Las Fyzical LLCGroup PAC ID 4880820844, 30 clinicians

Practice addresses (Care Compare)

9005 S Pecos Rd
Suite 2520
Henderson, NV 89074-7191
Phone (702) 818-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3960NVMDPhysical Therapist

Organizations & group practices 1

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": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1154887511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9070 W CHEYENNE AVE STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891298935",
            "telephone_number": "702-818-5000",
            "fax_number": "702-818-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9005 S PECOS RD STE 2520",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747191",
            "telephone_number": "702-818-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1590 W Sunset Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890146633",
            "country_code": "US",
            "telephone_number": "702-818-5000",
            "fax_number": "702-818-5001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 N Buffalo Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891450397",
            "country_code": "US",
            "telephone_number": "702-818-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9070 W Cheyenne Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891298935",
            "country_code": "US",
            "telephone_number": "702-818-5000",
            "fax_number": "702-818-5001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KENNETH",
        "middle_name": "FREDRICK",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-11",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "3960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; 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.