Breanne Konichek

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT-2025-0198 Issued in NM

Practice address

805 N Richardson Ave
Roswell, NM 88201-4920

Phone

(575) 622-6260

NPI assigned

Jan 27, 2021

Last updated

Nov 19, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sentry Safety and Physical Therapy Specialists LLCGroup PAC ID 2264730860, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sentry Safety and Physical Therapy Specialists, LLC

  • Physical Therapist
  • Roswell, NM
  • NPI 1619349743

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Sentry Home Health Care LLC

  • Home Health Agency
  • Roswell, NM
  • NPI 1538828835
  NPD
• Kommunikare Therapy PC

  • Speech-Language Pathologist
  • Hobbs, NM
  • NPI 1881251916

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1619568276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 E CROSSROADS",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882039011",
            "telephone_number": "575-910-0268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N RICHARDSON AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882014920",
            "telephone_number": "575-622-6260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "610 W Bender Blvd Ste 1300",
            "address_purpose": "LOCATION",
            "city": "Hobbs",
            "state": "NM",
            "postal_code": "882402241",
            "country_code": "US",
            "telephone_number": "575-433-2002",
            "fax_number": "888-729-4956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONICHEK",
        "first_name": "BREANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-27",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "OT-2025-0198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM OTA LICENSE",
            "identifier": "OTA4415",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Knight
• Knoche Chiropractic
• Dennis D Knoche, D.C.
• Christian Knudson
• Rachel Ellen Kobayashi
• Dawn R Korf, PA-C
• Valsala Koshy, MD
• Kali Kundomal, DNP, BSN, RN
• Yashdev Rohin Kundomal, PH. D., PT
• Morgan Lynn Kyser

• Occupational Therapist in Roswell, NM
• Providers in Roswell, NM by specialty
• Occupational Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; 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.