Sitasravya Devathi, MBBS
Individual provider Active NPI Internal Medicine Physician · Hermantown, MN
NPI 1881972206 · NPPES record last updated May 7, 2025
Key facts
- NPI
- 1881972206
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 57722 (MN)
- Practice address
- 4855 W Arrowhead Rd
Hermantown, MN 55811-3936 - Phone
- (218) 786-8364
- NPI assigned
- Aug 2, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 30
Hospital & facility affiliations 12
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Polinsky Medical Rehabilitation Center
The Duluth Clinic LTD
Practice addresses (Care Compare)
1600 Miller Trunk Hwy
Duluth, MN 55811-5640
Phone (218) 786-5360
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364
Hospital & facility affiliations
- Aveanna Home Health
- Centerwell Home Health
- Essentia Health Moose Lake Home Care
- Benedictine Home Health Duluth
- Essentia Health Duluth
- St Marys Hospital Superior
- Essentia Health St Mary'S Medical Center
- Essentia Health Virginia
- Essentia Health Moose Lake
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WI, MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140610001241 | WI | Practitioner - Internal Medicine | 5890919039 | Reassigns benefits to 2 organizations |
| I20140610001382 | MN | Practitioner - Internal Medicine |
5890919039 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57722 | MN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Mary'S Hospital of Superior | Current |
Accepting new patients | |
| The Duluth Clinic, LTD. | Current |
Accepting new patients | |
| The Duluth Clinic, LTD | Current |
Accepting new patients | |
| The Duluth Clinic, LTD | Current | Accepting new patients | |
| St. Mary'S Hospital of Superior | Current |
Accepting new patients | |
| The Duluth Clinic LTD | Current | Accepting new patients | |
| The Duluth Clinic, LTD | Past | Accepting new patients |
Locations
407 E 3rd St
Duluth, MN 55805
Phone (218) 786-4357
400 E 3rd St
#2
Duluth, MN 55805
Phone (218) 786-8319
420 E 1st St
Duluth, MN 55805
Phone (218) 786-1265
400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364
4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540
3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 57722 | MN | |
| Internal Medicine Physician | 207R00000X | 57722 | MN | Yes |
Addresses
Primary practice location
4855 W Arrowhead Rd
Hermantown, MN 55811-3936
Mailing address
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364
Other providers in Hermantown, MN
- Stephen Glenn Dahlgren
- Ashley Dammer
- Bailey Ann Dee
- Maia Eliz Defoe
- Ronald Lee Defrance
- Directions for Life Pca Services
- Directions for Life Pca Services, LLC
- Jocelyn A. Dorscher
- Jenna Lynn Dougherty
- Melanie Dubbin
All providers in Hermantown, MN · Internal Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.