KYLE RICHARD LATACK MD
NPI 1710567417
Obstetrics & Gynecology in Ann Arbor, MI

Q: What is Kyle Latack's NPI number?

The NPI number for Kyle Latack is 1710567417. It was assigned to this individual provider in the NPPES registry on April 8, 2021.

Q: What is Kyle Latack's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Q: When was this NPI record last updated?

The NPPES record for Kyle Latack was last updated on May 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.

Active since April 08, 2021PECOS Enrolled

1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109(734) 936-4000 Get Directions Write a Review

NPPES record last updated: May 13, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 13, 2025, Apr 8, 2021 (2 updates tracked since 2021).

On this page

About Kyle Richard Latack Md NPPES

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

KYLE RICHARD LATACK MD (NPI 1710567417) is an individual obstetrics & gynecology provider in Ann Arbor, Michigan, licensed in Michigan (4301513758) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710567417

Entity TypeIndividualMale

Primary Taxonomy207V00000X

Provider Legal NameKYLE RICHARD LATACKCredential: MD

Location Address1500 E MEDICAL CENTER DRAnn Arbor, MI 48109-5000

Mailing Address3621 S State StAnn Arbor, MI 48108-1633 · (734) 647-5299

Phone(734) 936-4000

Sole ProprietorNo

Enumeration DateApril 8, 2021

Last NPPES UpdateMay 13, 20252 updates tracked since enumeration

NPPES CertifiedMay 13, 2025

✔ NPI 1710567417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

License✔ Licensed in MI · 4301513758

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1500 E MEDICAL CENTER DR, Ann Arbor, MI 48109

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kyle Richard Latack Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kyle Latack reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Regents Of The University Of Michigan

Same address

Obstetrics & Gynecology

1500 E MEDICAL CENTER DR
Ann Arbor, MI 48109

Reassigned Medicare billing, Michigan enrollment
128 clinicians in this Medicare group

NPI 1639104854 (734) 936-4000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48109 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

$134.28 typical visit price

range $58.04 – $177.36

Typical copayment $33.57 (range $14.51 – $44.34)

Most-billed visit code 99204

Established Patient

$72.38 typical visit price

range $18.32 – $143.49

Typical copayment $18.09 (range $4.58 – $35.87)

Most-billed visit code 99213

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 20

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

LOKMAN SUNG MD

Pathology (Forensic Pathology)

1500 E MEDICAL CENTER DR, 2ND FLOOR UNIVERSITY HOSPITAL RECP PATHOLOGY
ANN ARBOR, MI 48109

Washtenaw County (800) 862-7284

SAMEER DEV SAINI M.D.

Internal Medicine (Gastroenterology)

1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109

Washtenaw County (734) 936-4000

KYLE DAVID PERRY MD

Pathology (Cytopathology)

1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109

Washtenaw County (734) 936-4000

DR. DAVID ALEXANDER STEWART M.D.

Pediatrics

1500 E MEDICAL CENTER DR, 12TH FLOOR C.S. MOTT CHILDREN'S HOSPITAL ROOM 525
ANN ARBOR, MI 48109

Washtenaw County (734) 763-5302

DR. MICHAEL EDMUND WATSON MD

Pediatrics (Pediatric Infectious Diseases)

1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109

Washtenaw County (734) 936-4000

CARRIE KRAEGER PORTER PA-C

Physician Assistant

1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109

Washtenaw County (734) 936-6666

DENISE LYNN BERRY CRNA

Nurse Anesthetist, Certified Registered

1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109

Washtenaw County (734) 936-4000

KETTI SOPHIA PETERSEN MD

Family Medicine (Hospice and Palliative Medicine)

1500 E MEDICAL CENTER DR
ANN ARBOR, MI 48109

Washtenaw County (734) 936-4000

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 Kyle Latack's NPI number?

The NPI number for Kyle Latack is 1710567417. It was assigned to this individual provider in the NPPES registry on April 8, 2021.

Where is Kyle Latack located?

Kyle Latack practices at 1500 E Medical Center Dr, Ann Arbor, MI 48109. The listed phone number is (734) 936-4000.

What is Kyle Latack's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Kyle Latack enrolled in Medicare?

Yes. Kyle Latack is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kyle Latack's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kyle Latack reassigns Medicare benefits to Regents Of The University Of Michigan (Ann Arbor, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kyle Latack's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kyle Latack was last updated on May 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.