Individual provider Active NPI

Gebi Tufaa

  • Adult Care Home Facility
  • Blaine, MN
National Provider Identifier
1124930078
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
1066367 Issued in MN
Practice address
11536 Yancy CT NE
Blaine, MN 55449-5940
Phone
(763) 742-2225
NPI assigned
Sep 17, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 1066367 MN Primary

Addresses

Primary practice location

11536 Yancy CT NE
Blaine, MN 55449-5940

Mailing address

11536 Yancy CT NE
Blaine, MN 55449-5940
Phone (763) 742-2225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1124930078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11536 YANCY CT NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495940",
            "telephone_number": "763-742-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11536 YANCY CT NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495940",
            "telephone_number": "763-742-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUFAA",
        "first_name": "GEBI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-17",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MN",
            "license": "1066367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.