NPIMap

Individual provider Active NPI

Nicole S Burkette Ikebata, MD, MPH

  • Psychiatry Physician
  • Roseville, MN
National Provider Identifier
1972964849
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
66384 Issued in MN
Practice address
2355 Highway 36 W Ste 400
Roseville, MN 55113-3905
Phone
(651) 243-8113
Fax
(931) 202-8451
NPI assigned
Mar 18, 2016
Last updated
Jun 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X DR.0076759 CO
Psychiatry Physician 2084P0800X 66384 MN Primary
Psychiatry Physician 2084P0800X MD-55795 IA

Addresses

Primary practice location

2355 Highway 36 W Ste 400
Roseville, MN 55113-3905

Mailing address

2355 Highway 36 W Ste 400
Roseville, MN 55113-3905
Phone (651) 243-8113

Other practice location 1

345 Smith Ave N
Saint Paul, MN 55102-2346
Phone (651) 220-6700

Other practice location 2

280 Smith Ave N Ste 450
Saint Paul, MN 55102-2481
Phone (651) 241-5959

Other practice location 3

308 E Burlington St
Iowa City, IA 52240-1602
Phone (651) 243-8113

Other practice location 4

2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone (612) 813-6000

Other practice location 5

3609 Austin Bluffs Pkwy Ste 31
Colorado Springs, CO 80918-6658
Phone (205) 964-2924

Other names 1

  • Nicole Ikebata Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nburketteikebata477217@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, IA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210920003144 MN Practitioner - Psychiatry 7416388178 Reassigns benefits to 1 organization
I20260608003157 IA Practitioner - Psychiatry 7416388178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

1825 Logan Ave
Waterloo, IA 50703-1916
Phone (319) 235-3913

1873 Shryer Ave W
Roseville, MN 55113-5413
Phone (319) 235-3941

233 Vold Dr
Waterloo, IA 50703-1256
Phone 31923550900

280 Smith Ave N
Suite 450
St Paul, MN 55102-2481
Phone (651) 241-5959

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0076759COMDPsychiatry Physician
MD-55795IAMDPsychiatry Physician
66384MNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maple Psychiatry Psychiatry CurrentSince Jun 1, 2026 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Feb 9, 2026 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
SMDC Medical Center Past Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

502 E 2nd St
Duluth, MN 55805
Phone (218) 727-8762

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

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

800 E 28th St
Fl 6
Minneapolis, MN 55407
Phone (612) 863-5327

280 Smith Ave N
Ste 450
Saint Paul, MN 55102
Phone (651) 241-5959

Interoperability endpoints

  • Direct secure messaging: nburketteikebata477217@excellian.direct.allina.com

Organizations & group practices 6

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.

Hospital & facility affiliations 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1972964849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W STE 400",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "651-243-8113",
            "fax_number": "931-202-8451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W STE 400",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "651-243-8113",
            "fax_number": "931-202-8451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 Smith Ave N",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551022346",
            "country_code": "US",
            "telephone_number": "651-220-6700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "280 Smith Ave N Ste 450",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551022481",
            "country_code": "US",
            "telephone_number": "651-241-5959",
            "fax_number": "651-241-5958",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "308 E Burlington St",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522401602",
            "country_code": "US",
            "telephone_number": "651-243-8113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2525 Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554044518",
            "country_code": "US",
            "telephone_number": "612-813-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3609 Austin Bluffs Pkwy Ste 31",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809186658",
            "country_code": "US",
            "telephone_number": "205-964-2924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURKETTE IKEBATA",
        "first_name": "NICOLE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-18",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0076759",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "66384",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "MD-55795",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nburketteikebata477217@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "280 Smith Ave N Ste 450",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551022481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "IKEBATA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.