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

Alwin Edakkunnathu, OD

Individual provider Optometrist · NPI 1467899609

Alwin Edakkunnathu, OD is an Optometry in Glendale, Wisconsin. Graduated from Illinois College of Optometry at Chicago in 2009, 17 years ago. Practices with Madison Medical Affiliates Inc, a 86-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
17
Trained at
Illinois College of Optometry at Chicago
Licensed in
WI
In the registry since
2013
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

5150 N Port Washington Rd Ste 251
Glendale, WI 53217-5477
Phone: (414) 332-0606
Fax: (414) 967-3604
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 10320 N Port Washington Rd, Mequon, WI 53092-5767 — (262) 241-1919
  • 620 E Green Bay Ave Ste 124, Saukville, WI 53080-2047 — (262) 241-1919

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 3300-35 (WI)

Record details

NPI number1467899609
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedMay 29, 2013
Last updated in NPPESApril 17, 2021
Certification dateApril 17, 2021

Medicare enrollment

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

Medicare specialtyOPTOMETRY
Medical schoolILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Graduated 2009 (17 years in practice)
Group practice Madison Medical Affiliates Inc — 86 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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