Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly Bourgon, OD

Individual provider Optometrist · NPI 1194213751

Kelly Bourgon, OD is an Optometry in Longmont, Colorado. Graduated from Pacific University - College of Optometry in 2018, 8 years ago. Practices with Eye Care Associates of Co LLC, a 62-clinician group and accepts Medicare assignment. Licensed in Colorado and New York.

Years since qualifying
8
Trained at
Pacific University - College of Optometry
Licensed in
CO, NY
In the registry since
2018
Specialties on file
2
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

412 Main St
Longmont, CO 80501-5535
Phone: (303) 651-6700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 3557 (CO)
Optometrist Taxonomy 152W00000X · Licence TUV008844 (NY)

Record details

NPI number1194213751
Entity typeIndividual (Type 1)
GenderFemale
Credentials OD
Sole proprietorNo
NPI enumeratedApril 28, 2018
Last updated in NPPESJanuary 30, 2023
Certification dateJanuary 30, 2023
Mailing address1768 S Taft Ave Apt 103, Loveland, CO 80537-7291

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolPACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Graduated 2018 (8 years in practice)
Group practice Eye Care Associates Of Co Llc — 62 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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