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DR. JESSICA LATACK PHD
NPI 1659884377
Psychologist - Clinical in New York, NY

Active since November 16, 2017Opted out of Medicare · through Nov 26, 2027
200 W 57TH ST STE 507, NEW YORK, NY 10019(917) 817-2422 Get Directions Write a Review

NPPES record last updated: August 19, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 19, 2019, Jul 12, 2019, Mar 23, 2018 and 1 more (4 updates tracked since 2017).

About Dr. Jessica Latack Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JESSICA LATACK PHD (NPI 1659884377) is an individual clinical provider in New York, New York, licensed in New York (022815) and active in the NPI registry since November 2017. She has opted out of Medicare through November 26, 2027 and remains eligible to order and refer and maintains a secondary practice location in New York.

NPPES Registry Identity

NPI1659884377
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. JESSICA LATACKCredential: PHD
Location Address200 W 57TH ST STE 507New York, NY 10019-3211
Mailing Address115 W 86th StNew York, NY 10024-3410
Phone(917) 817-2422
Sole ProprietorYes
Enumeration DateNovember 16, 2017
Last NPPES UpdateAugust 19, 20194 updates tracked since enumeration
✔ NPI 1659884377 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in NY · 022815
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
200 W 57TH ST STE 507, New York, NY 10019
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Secondary Practice Location 1

Location 1425 E 61st St Rm 1363New York, NY 10065-8722 · Phone (734) 604-2587

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jessica Latack Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 26, 2019 through November 26, 2027.

Opt-Out Effective DateNovember 26, 2019
Opt-Out In Effect ThroughNovember 26, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10019 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$198.19 typical visit price
range $65.69 – $198.19
Typical copayment $49.54 (range $16.42 – $49.54)
Most-billed visit code 99205
Established Patient
$114.88 typical visit price
range $21.20 – $160.66
Typical copayment $28.72 (range $5.30 – $40.16)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SUSAN KARABELL MD
Psychiatry & Neurology (Psychiatry)
200 W 57TH ST STE 507
NEW YORK, NY 10019
New York County (929) 249-0670
DR. MEGAN HUGHES FELTENBERGER PH.D.
Psychologist
200 W 57TH ST STE 507
NEW YORK, NY 10019
New York County (212) 484-9775

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jessica Latack's NPI number?

The NPI number for Jessica Latack is 1659884377. It was assigned to this individual provider in the NPPES registry on November 16, 2017.

Where is Jessica Latack located?

Jessica Latack practices at 200 W 57th St Ste 507, New York, NY 10019. The listed phone number is (917) 817-2422.

What is Jessica Latack's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jessica Latack enrolled in Medicare?

No. Jessica Latack has opted out of Medicare through November 26, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Jessica Latack was last updated on August 19, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.