NPIMap

Individual provider Active NPI

Michalene Marie Stevermer, D.O.

  • Psychiatry Physician
  • Duluth, MN
National Provider Identifier
1609134782
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
57910 Issued in MN
Practice address
220 N 6TH Ave E
Duluth, MN 55805-1952
Phone
(218) 249-7000
Fax
(218) 249-7050
NPI assigned
Apr 26, 2012
Last updated
Jan 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 57910 MN Primary

Addresses

Primary practice location

220 N 6TH Ave E
Duluth, MN 55805-1952

Mailing address

220 N 6TH Ave E
Duluth, MN 55805-1952
Phone (218) 249-7000

Other names 1

  • Michalene Marie Otis Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

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
I20161013001107 MN Practitioner - Psychiatry 1951531797 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke's Hospital of DuluthGroup PAC ID 7113834839, 409 clinicians

Practice addresses (Care Compare)

220 N 6TH Ave E
Duluth, MN 55805-1952
Phone (218) 249-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57910MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital of Duluth CurrentSince Oct 3, 2016 Accepting new patients
Lake View Memorial Hospital, Inc CurrentSince Dec 7, 2025 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
Lake View Memorial Hospital, Inc. CurrentSince Dec 7, 2025 Accepting new patients
St. Luke's Hospital of Duluth Current Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Oct 3, 2016 Accepting new patients
Lake View Memorial Hospital, Inc CurrentSince Dec 7, 2025 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

220 N 6th Ave E
Duluth, MN 55805
Phone (218) 249-7000

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

325 11th Ave
Two Harbors, MN 55616
Phone (218) 834-5520

Interoperability endpoints

  • Direct secure messaging: him@slk.direct.slhduluth.com
  • Direct secure messaging: mstevermer237591@direct.aspirus.org
  • Direct secure messaging: michalene.stevermer@slk.direct.slhduluth.com
  • Direct secure messaging: michalene.stevermer@lkv.direct.slhduluth.com

Organizations & group practices 7

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 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1609134782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N 6TH AVE E",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051952",
            "telephone_number": "218-249-7000",
            "fax_number": "218-249-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N 6TH AVE E",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051952",
            "telephone_number": "218-249-7000",
            "fax_number": "218-249-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVERMER",
        "first_name": "MICHALENE",
        "middle_name": "MARIE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-26",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "57910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "220 N 6th Ave E",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558051952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MICHALENE",
            "last_name": "OTIS",
            "middle_name": "MARIE",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.