Individual provider Active NPI

Dillon Boen

  • Internal Medicine Physician
  • Fergus Falls, MN
National Provider Identifier
1811798093
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
15385 Issued in MN
Practice address
111 W Vernon Ave
Fergus Falls, MN 56537-2741
Phone
(218) 739-2221
NPI assigned
Mar 22, 2025
Last updated
May 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 15385 MN Primary

Addresses

Primary practice location

111 W Vernon Ave
Fergus Falls, MN 56537-2741

Mailing address

111 W Vernon Ave
Fergus Falls, MN 56537-2741
Phone (218) 739-2221

Other practice location 1

111 W Vernon Ave
Fergus Falls, MN 56537-2741
Phone (218) 739-2221

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
I20250911004150 MN Practitioner - Physician Assistant 4981107315 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

111 W Vernon Ave
Fergus Falls, MN 56537-2741
Phone (218) 739-2221

649 /2 State St NW
Evansville, MN 56326-8124
Phone (218) 948-2040

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15385MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Region Healthcare Corporation CurrentSince Sep 1, 2025 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Sep 1, 2025 Accepting new patients

Locations

1411 Highway 79 E
Elbow Lake, MN 56531
Phone (218) 685-7300

649 State St NW
Evansville, MN 56326
Phone (218) 948-2040

111 W Vernon Ave
Fergus Falls, MN 56537
Phone (218) 736-5770

712 S Cascade St
Fergus Falls, MN 56537

Organizations & group practices 3

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 2

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": "1742601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1811798093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W VERNON AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372741",
            "telephone_number": "218-739-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W VERNON AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372741",
            "telephone_number": "218-739-2221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 W Vernon Ave",
            "address_purpose": "LOCATION",
            "city": "Fergus Falls",
            "state": "MN",
            "postal_code": "565372741",
            "country_code": "US",
            "telephone_number": "218-739-2221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOEN",
        "first_name": "DILLON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-22",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "15385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fergus Falls, MN

Sources for this page

Verify at the official NPI Registry.