Individual Healthcare Provider
Fatima Sufi, SYSTEM ADMINISTRATOR
Provider's NPPES record last updated: March 6, 2023
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1861192353
- Primary Specialty
- Clinic/Center — Rehabilitation
- Practice Location
- Chaska, Minnesota
- Sole Proprietor
- Yes
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 19, 2026, 9:31 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Clinic/Center
Rehabilitation
Ambulatory Health Care Facilities
Definition to come...
Taxonomy code 261QR0400X Social Worker
Clinical
Behavioral Health & Social Service Providers
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Taxonomy code 1041C0700XDentist
Dental Providers
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Taxonomy code 122300000XNursing Care
Agencies
A Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services.
Taxonomy code 251J00000XFoster Care Agency
Agencies
A Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as "24-hour substitute care for children outside their own homes." Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes.
Taxonomy code 253J00000XClinic/Center
Ambulatory Health Care Facilities
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Taxonomy code 261Q00000XClinic/Center
Recovery Care
Ambulatory Health Care Facilities
Definition to come...
Taxonomy code 261QR0800XAssisted Living Facility
Nursing & Custodial Care Facilities
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
Taxonomy code 310400000X
Provider-Reported License Information
- Clinic/Center (Minnesota)
- 411159
- Social Worker (Minnesota)
- 411159
- Dentist (Minnesota)
- 411159
- Nursing Care (Minnesota)
- 411159
- Foster Care Agency (Minnesota)
- 411159
- Clinic/Center (Minnesota)
- 411159
- Clinic/Center (Minnesota)
- 411159
- Assisted Living Facility (Minnesota)
- 411159
Practice Locations
Practice Location
1107 Hazeltine Blvd Ste 484
Chaska, Minnesota 55318-1065
Phone: (612) 446-5480
Record Information
- Enumeration Date
- March 6, 2023
- Provider's NPPES Record Last Updated
- March 6, 2023
- Certification Date
- March 6, 2023
- NPISignal NPPES Dataset
- August 2026
See Something Wrong?
Incorrect provider information
Everything on this page comes directly from the NPPES data CMS publishes. NPISignal cannot edit a provider's record — only the provider or organization can, directly through NPPES.
Update a record through NPPESSomething wrong with this page?
If NPISignal is displaying this data incorrectly — a formatting error, a broken link, a mismatch with the source file — let us know.
Report a display issue