Individual provider Active NPI

Alejandra Paloma Obiedat, PT

  • Physical Therapist
  • Brookfield, WI
National Provider Identifier
1205510047
Registry record updated Feb 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16400-024 Issued in WI
Practice address
19700 W Bluemound Rd
Brookfield, WI 53045-5909
Phone
(262) 797-8676
NPI assigned
Jun 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 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 16400-024 WI Primary

Addresses

Primary practice location

19700 W Bluemound Rd
Brookfield, WI 53045-5909

Mailing address

19700 W Bluemound Rd
Brookfield, WI 53045-5909

Other names 1

  • Alejandra Paloma Obiedat Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250418002133 WI Practitioner - Physical Therapist in Private Practice 4486000452

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16400-024WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Axes Physical Therapy, LLC Physical Therapist CurrentSince Aug 27, 2023 Accepting new patients
Axes Physical Therapy, LLC Physical Therapist CurrentSince Aug 27, 2023 Accepting new patients

Locations

14081 Manchester Rd
Ballwin, MO 63011
Phone (636) 223-5700

647 Spirit Airpark West Dr
Ste 101
Chesterfield, MO 63005
Phone (636) 223-5700

1195 Hazel Ln
Farmington, MO 63640
Phone (573) 756-2937

4273 Keaton Crossing Blvd
O Fallon, MO 63368
Phone (636) 206-4225

4131 Union Rd
Saint Louis, MO 63129
Phone (314) 274-9222

21 Silo Dr
Union, MO 63084
Phone (636) 649-4131

2018 Phoenix Center Dr
Washington, MO 63090
Phone (314) 718-4560

Organizations & group practices 2

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": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772236800000",
    "number": "1205510047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19700 W BLUEMOUND RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19700 W BLUEMOUND RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530455909",
            "telephone_number": "262-797-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBIEDAT",
        "first_name": "ALEJANDRA",
        "middle_name": "PALOMA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2026-02-28",
        "certification_date": "2026-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "16400-024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEJANDRA",
            "last_name": "OBIEDAT",
            "middle_name": "PALOMA",
            "credential": "PERALTA-WERNS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.