NPIMap

Individual provider Active NPI

Souad N Brobby, PA

  • Physician Assistant
  • Savage, MN
National Provider Identifier
1508800285
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11041 Issued in MN
Practice address
6350 W 143Rd St Ste 200
Savage, MN 55378-2890
Phone
(952) 428-1010
NPI assigned
Jun 15, 2006
Last updated
Dec 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA04869 TX
Physician Assistant 363A00000X 11041 MN Primary

Addresses

Primary practice location

6350 W 143Rd St Ste 200
Savage, MN 55378-2890

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Other practice location 1

200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other identifiers 1

IdentifierTypeStateIssuer
8X6086OtherTXBCBS

Other names 1

  • Souad Nashief Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sbrobby638297@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121126000598 MN Practitioner - Physician Assistant 5991727877 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Twin Cities Physicians Professional CorporationGroup PAC ID 9830499763, 66 clinicians
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

1415 Lilac Dr N
Suite 190
Golden Valley, MN 55422-4544
Phone (763) 267-8701

1880 N Frontage Rd
Hastings, MN 55033-2687
Phone (612) 775-6200

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

701 Dellwood St S
Cambridge, MN 55008-1920
Phone (763) 688-8700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
11041MNMDPhysician Assistant
PA04869TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Glencoe Regional Health Services CurrentSince Sep 9, 2023 Accepting new patients
Glencoe Regional Health Services CurrentSince Sep 9, 2023 Accepting new patients
Group Health, Inc. CurrentSince Jun 3, 2013 Accepting new patients
Fairview Health Services CurrentSince May 18, 2013 Accepting new patients
Allina Health System CurrentSince Aug 5, 2023 Accepting new patients
Group Health, Inc. CurrentSince Jun 3, 2013 Accepting new patients
Allina Health System CurrentSince Aug 5, 2023 Accepting new patients
Fairview Health Services CurrentSince May 18, 2013 Accepting new patients
Allina Health System Past Accepting new patients
Texas Children's Hospital Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700

1805 Hennepin Ave N
Glencoe, MN 55336
Phone (320) 864-3121

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

9200 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 881-8676

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

6350 W 143rd St
Ste 200
Savage, MN 55378
Phone (952) 428-1010

5565 Blaine Ave
South St Paul, MN 55076
Phone (651) 241-9400

Interoperability endpoints

  • Direct secure messaging: sbrobby638297@excellian.direct.allina.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1508800285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6350 W 143RD ST STE 200",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553782890",
            "telephone_number": "952-428-1010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROBBY",
        "first_name": "SOUAD",
        "middle_name": "N",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04869",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8X6086",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbrobby638297@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/TXT/PDF",
            "address_1": "6350 W 143rd St Ste 200",
            "city": "Savage",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553782890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SOUAD",
            "last_name": "NASHIEF",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Savage, MN

Sources for this page

Verify at the official NPI Registry.