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

Martin Alex Mundackal, OD

Individual provider Optometrist · NPI 1114816634

Martin Alex Mundackal, OD is an Optometry in New York, New York. Graduated from State University of New York - State College Optometry in 2024, 2 years ago. Licensed in New York.

Years since qualifying
2
Trained at
State University of New York - State College Optometry
Licensed in
NY
In the registry since
2025
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

4204 Broadway
New York, NY 10033-3706
Phone: (917) 920-2636
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 011180 (NY)

Record details

NPI number1114816634
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedJune 30, 2025
Last updated in NPPESJuly 7, 2025
Certification dateJuly 7, 2025

Medicare enrollment

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

Medicare specialtyOPTOMETRY
Medical schoolSTATE UNIVERSITY OF NEW YORK - STATE COLLEGE OPTOMETRY
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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