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
Mailing address3740 E Crossroads, Roswell, NM 88203-9011

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