Individual provider Active NPI

Daniel P Boll, PA-C

  • Medical Physician Assistant
  • Brainerd, MN
National Provider Identifier
1225289689
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10494 Issued in MN
Practice address
2024 S 6TH St
Brainerd, MN 56401-3054
Phone
(218) 828-7100
NPI assigned
Oct 3, 2008
Last updated
Jun 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10494 MN Primary

Addresses

Primary practice location

2024 S 6TH St
Brainerd, MN 56401-3054

Mailing address

111 17TH Ave E
Alexandria, MN 56308-5273
Phone (320) 762-1511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081120000761 MN Practitioner - Physician Assistant 1254491269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alomere HealthGroup PAC ID 9931690047, 123 clinicians

Practice addresses (Care Compare)

111 17TH Ave E
Alexandria, MN 56308-5273
Phone (320) 762-1511

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1202MNMDMarriage & Family Therapist
10494MNMDVeterinarian

Practice roles

OrganizationSpecialtyStatusNew patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
Alomere Health CurrentSince Jan 1, 2026 Accepting new patients
West Central Pathology and Laboratory Medicine PA Current Accepting new patients
Centracare Health System Past Accepting new patients
St. Joseph's Medical Center Past Accepting new patients

Locations

111 17th Ave E
Alexandria, MN 56308
Phone (320) 762-1511

Interoperability endpoints

  • Direct secure messaging: dboll14103@direct.centracare.com

Organizations & group practices 5

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 1

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": "1222992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1225289689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 17TH AVE E",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563085273",
            "telephone_number": "320-762-1511",
            "fax_number": "320-762-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 S 6TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013054",
            "telephone_number": "218-828-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLL",
        "first_name": "DANIEL",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-03",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "10494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brainerd, MN

Sources for this page

Verify at the official NPI Registry.