Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MR. KENNETH-ALBERT FABABAER VALENZUELA PT
NPI 1558779876
Physical Therapist in Neosho, MO

Active since July 30, 2014
1105 VILLAGE RD, NEOSHO, MO 64850(800) 381-0822 Get Directions Write a Review

NPPES record last updated: October 6, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Mr. Kenneth-albert Fababaer Valenzuela Pt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KENNETH-ALBERT FABABAER VALENZUELA PT (NPI 1558779876) is an individual physical therapist in Neosho, Missouri, licensed in Illinois (070020735) and active in the NPI registry since July 2014. He maintains a secondary practice location in Forest Park.

NPPES Registry Identity

NPI1558779876
Entity TypeIndividualMale
Primary Taxonomy225100000X
Provider Legal NameMR. KENNETH-ALBERT FABABAER VALENZUELACredential: PT
Location Address1105 VILLAGE RDNeosho, MO 64850-9076
Mailing Address8477 S Suncoast BlvdHomosassa, FL 34446-5028 · (800) 381-0822
Sole ProprietorYes
Enumeration DateJuly 30, 2014
Last NPPES UpdateOctober 6, 2026
NPPES CertifiedOctober 6, 2026
✔ NPI 1558779876 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
Licenses✔ Licensed in IL · 070020735✔ Licensed in DE · J1-0003168
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
1105 VILLAGE RD, Neosho, MO 64850

Secondary Practice Location 1

Location 17440 Harrison St Apt 2Forest Park, IL 60130-2085 · Phone (708) 790-9577

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Kenneth-albert Fababaer Valenzuela Pt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Kenneth-albert Valenzuela reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Physical Therapist
1035 MADISON ST
Oak Park, IL 60302
  • Reassigned Medicare billing, Illinois enrollment
  • 99 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Occupational Therapy Assistant
1105 VILLAGE RD
NEOSHO, MO 64850
Physical Therapy Assistant
1105 VILLAGE RD
NEOSHO, MO 64850
Occupational Therapy Assistant
1105 VILLAGE RD
NEOSHO, MO 64850
Physical Therapy Assistant
1105 VILLAGE RD
NEOSHO, MO 64850
Physical Therapy Assistant
1105 VILLAGE RD
NEOSHO, MO 64850
Physical Therapy Assistant
1105 VILLAGE RD
NEOSHO, MO 64850
Occupational Therapy Assistant
1105 VILLAGE RD
NEOSHO, MO 64850
Occupational Therapy Assistant
1105 VILLAGE RD
NEOSHO, MO 64850

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 Kenneth-albert Valenzuela's NPI number?

The NPI number for Kenneth-albert Valenzuela is 1558779876. It was assigned to this individual provider in the NPPES registry on July 30, 2014.

Where is Kenneth-albert Valenzuela located?

Kenneth-albert Valenzuela practices at 1105 Village Rd, Neosho, MO 64850. The listed phone number is (800) 381-0822.

What is Kenneth-albert Valenzuela's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Kenneth-albert Valenzuela enrolled in Medicare?

Yes. Kenneth-albert Valenzuela is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kenneth-albert Valenzuela's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth-albert Valenzuela reassigns Medicare benefits to Paxxon Healthcare Services LLC (Oak Park, IL). The 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 Kenneth-albert Valenzuela's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kenneth-albert Valenzuela was last updated on October 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 40 days 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.