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

Dr. Michael Joseph Bannon, OD

Individual provider Optometrist · NPI 1124645585

Dr. Michael Joseph Bannon, OD is an Optometry in Watertown, Wisconsin. Graduated from Illinois College of Optometry at Chicago in 2020, 6 years ago. Practices with Shoptikal LLC, a 192-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
6
Trained at
Illinois College of Optometry at Chicago
Licensed in
WI
In the registry since
2020
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

1500 S Church St
Watertown, WI 53094-6404
Phone: (920) 261-9225
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 3625-35 (WI)

Record details

NPI number1124645585
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedJuly 1, 2020
Last updated in NPPESJuly 1, 2020
Certification dateJuly 1, 2020

Medicare enrollment

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

Medicare specialtyOPTOMETRY
Medical schoolILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Graduated 2020 (6 years in practice)
Group practice Shoptikal Llc — 192 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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