Hi @Hunter Nance,
There are currently no known types of files that cannot be uploaded into SharePoint. And there is no OOTB way to restrict specific file types in the SharePoint Online.
As a workaround, you could create a flow which auto-runs on each file uploaded and if it matches the given specific file types(PHI,.PII in your case), auto-delete that document and send email to the author who uploaded it.
Compose 2 inputs:
last(split(triggerOutputs()?['body/{FilenameWithExtension}'],'.'))
Reference flow:
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