Dr Mark Joseph Bannon, OD is a medicare enrolled "Eyewear Supplier" provider in Kensington, Connecticut. His current practice location is
359 Main St, Kensington, Connecticut. You can reach out to his office (for appointments etc.) via phone at
(860) 829-1020.
Dr Mark Joseph Bannon is licensed to practice in Connecticut (license number 888) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1558417949.
Healthcare Provider's Profile
| Full Name | Dr Mark Joseph Bannon |
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| Gender | Male |
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| Speciality | Eyewear Supplier |
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| Location | 359 Main St, Kensington, Connecticut |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1558417949
- Provider Enumeration Date: 01/26/2007
- Last Update Date: 11/03/2008
Medicare PECOS Information:
- PECOS PAC ID: 0547382251
- Enrollment ID: I20110113000691
Medical Identifiers
Medical identifiers for Dr Mark Joseph Bannon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1558417949 | NPI | - | NPPES |
| 004101549 | Medicaid | CT | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 888 (Connecticut) | Secondary |
| 332H00000X | Eyewear Supplier | 888 (Connecticut) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mark Joseph Bannon is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Mark Joseph Bannon, OD
359 Main St,
Kensington, CT 06037-2651
Ph: (860) 829-1020 | Dr Mark Joseph Bannon, OD
359 Main St,
Kensington, CT 06037-2651
Ph: (860) 829-1020 |
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