Tonya K Bourn, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046008999 Issued in IL

Practice address

12101 Woodcrest Executive Dr Ste 150
Creve Coeur, MO 63141-5050

Phone

(314) 863-9966

NPI assigned

May 6, 2006

Last updated

Dec 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, MO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Surevision Eye Centers Midwest LLCGroup PAC ID 1850297904, 3 clinicians

Ideal Eye Surgery LLCGroup PAC ID 7315200888, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Alton Memorial Hospital Hospital, Alton, IL, CCN 140002
• Jersey Community Hospital Hospital, Jerseyville, IL, CCN 140059

Merit-based Incentive Payment System (MIPS)

Final score

93.26 of 100Reported as group

Quality

100

Improvement activities

40

Cost

77.53

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: tonya.bournod.p31@direct.surevision.nextgenshare.com

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.

• Surevision Eye Centers Midwest LLC

  dba SureVision Eye Centers

  • Ophthalmology Physician
  • Creve Coeur, MO
  • NPI 1699857912

  IL, Optometrist

  Medicare reassignment Care Compare group NPD
• Ideal Eye Surgery LLC

  • Ophthalmology Physician
  • O'Fallon, IL
  • NPI 1366966186

  MO

  Medicare reassignment Care Compare group NPD
• Surevision Eye Centers Midwest LLC

  • Durable Medical Equipment & Medical Supplies
  • Hazelwood, MO
  • NPI 1982839262
  NPD
• Retina Consultants, LLC

  dba The Retina Institute

  • Retina Specialist (Ophthalmology) Physician
  • Brentwood, MO
  • NPI 1700175395
  NPD (past)

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

• Alton Memorial Hospital

  • Ambulance
  • Alton, IL
  • NPI 1063669117

  Hospital

  Care Compare affiliation
• Alton Memorial Hospital

  • General Acute Care Hospital
  • Alton, IL
  • NPI 1548278476
  Care Compare affiliation
• Jersey Community Hospital

  • General Acute Care Hospital
  • Jerseyville, IL
  • NPI 1184630519
  Care Compare affiliation

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1851340152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12101 WOODCREST EXECUTIVE DR STE 150",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415050",
            "telephone_number": "314-391-9400",
            "fax_number": "618-861-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12101 WOODCREST EXECUTIVE DR STE 150",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631415050",
            "telephone_number": "314-863-9966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 Insight Ave",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "IL",
            "postal_code": "622692146",
            "country_code": "US",
            "telephone_number": "618-391-1660",
            "fax_number": "618-861-6003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Professional Dr",
            "address_purpose": "LOCATION",
            "city": "Alton",
            "state": "IL",
            "postal_code": "620025068",
            "country_code": "US",
            "telephone_number": "618-391-1660",
            "fax_number": "618-861-6003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12400 Olive Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631415454",
            "country_code": "US",
            "telephone_number": "314-391-9400",
            "fax_number": "618-861-6003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOURN",
        "first_name": "TONYA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-06",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008999",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2019047752",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Bolzenius, M. A.
• Bradley Elliott Borello, OD
• Abby Christine Boron, SLP
• Ramona Georgeta Bosma, D.M.D.
• Brian Douglass Bourbon, CERTIFIED PEDORTHIST
• Loren Nicole Boushey, COTA/L
• Nancy Claire Bradley, R.D., L.D., C.D.E.
• Gregory H Branham, MD
• Kent D Branson, M.D.
• Ernest L Brawner, LCSW CAS

• Optometrist in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.