NPIMap

Individual provider Active NPI

Habiba Alero Ikoghode, M.D.

  • Family Medicine Physician
  • Jackson, MN
National Provider Identifier
1669783106
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
106745 Issued in MN
Practice address
1430 North Hwy
Jackson, MN 56143-1093
Phone
(507) 847-2200
Fax
(507) 847-3808
NPI assigned
Jun 30, 2010
Last updated
Aug 20, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125058258 IL
Family Medicine Physician 207Q00000X 106745 MN Primary

Addresses

Primary practice location

1430 North Hwy
Jackson, MN 56143-1093

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

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
I20131112001927 MN Practitioner - Family Practice 5890933824 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians
Sanford Health NetworkGroup PAC ID 6800707100, shared by 49 NPIs, 357 clinicians

Practice addresses (Care Compare)

14040 Northdale Blvd
Rogers, MN 55374-9612
Phone (763) 488-4100

1430 N Hwy
Jackson, MN 56143-1093
Phone (507) 847-2200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
106745MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Current Accepting new patients
Sanford Health Network Family Medicine Current Accepting new patients
Fairview Express Care CurrentSince Feb 3, 2025 Accepting new patients
Sanford Health Network Current Accepting new patients
Fairview Clinics CurrentSince Sep 30, 2020 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Sep 30, 2020 Accepting new patients
Sanford Health Network CurrentSince Sep 30, 2013 Accepting new patients
Sanford Health Network Family Medicine Current Accepting new patients
Fairview Health Services CurrentSince Jan 4, 2019 Accepting new patients
Fairview Express Care CurrentSince Feb 3, 2025 Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

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

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

1430 North Hwy
Jackson, MN 56143
Phone (507) 847-2200

14500 99th Ave N
Maple Grove, MN 55369
Phone (763) 898-1000

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

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

14040 Northdale Blvd
Rogers, MN 55374
Phone (763) 241-5870

1018 6th Ave
Worthington, MN 56187
Phone (507) 343-6100

Interoperability endpoints

  • Direct secure messaging: hikoghode470052@fairview.direct-ci.com

Organizations & group practices 14

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 14

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1669783106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585",
            "fax_number": "605-328-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 NORTH HWY",
            "city": "JACKSON",
            "state": "MN",
            "postal_code": "561431093",
            "telephone_number": "507-847-2200",
            "fax_number": "507-847-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKOGHODE",
        "first_name": "HABIBA",
        "middle_name": "ALERO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125058258",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "106745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MN

Sources for this page

Verify at the official NPI Registry.