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

Breanne Konichek

Individual provider Occupational Therapist · NPI 1619568276

Breanne Konichek is an Occupational Therapist in Private Practice in Roswell, New Mexico. Qualified in 2025, 1 year ago. Practices with Sentry Safety and Physical Therapy Specialists LLC, a 4-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New Mexico.

Years since qualifying
1
Licensed in
NM
In the registry since
2021
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Practice location Address checks out

805 N Richardson Ave
Roswell, NM 88201-4920
Phone: (575) 622-6260
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 610 W Bender Blvd Ste 1300, Hobbs, NM 88240-2241 — (575) 433-2002

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence OT-2025-0198 (NM)

Record details

NPI number1619568276
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 27, 2021
Last updated in NPPESNovember 19, 2025
Certification dateNovember 19, 2025

Medicare enrollment

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

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Sentry Safety And Physical Therapy Specialists Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Roswell