Individual provider Active NPI

Latifa Berry, OD

  • Optometrist
  • Ypsilanti, MI
National Provider Identifier
1194613794
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005895 Issued in MI
Practice address
1769 Washtenaw Rd
Ypsilanti, MI 48197-2020
Phone
(734) 483-2100
Fax
(734) 483-2060
NPI assigned
Jun 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005895 MI Primary

Addresses

Primary practice location

1769 Washtenaw Rd
Ypsilanti, MI 48197-2020

Mailing address

30600 W. 12 Mile Rd.
Farmington Hills, MI 48334
Phone (248) 737-3937

Other practice location 1

30660 W 12 Mile Rd
Farmington Hills, MI 48334-3808
Phone (248) 310-8465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250718000530 MI Practitioner - Optometry 6406362383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ypsilanti Vision PCGroup PAC ID 1355642257, 2 clinicians

Practice addresses (Care Compare)

1769 Washtenaw Rd
Ypsilanti, MI 48197-2020
Phone (734) 483-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901005895MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ypsilanti Vision PC Optometrist CurrentSince Jun 15, 2025 Accepting new patients
2020 Family Vision Novi CurrentSince Aug 18, 2026 Accepting new patients
2020 Family Vision Ann Arbor Optometrist CurrentSince Aug 18, 2026 Accepting new patients
Gary M. Moss, O.D. PastSince Jun 15, 2025 Accepting new patients

Locations

4723 Washtenaw Ave
Ann Arbor, MI 48108
Phone (248) 310-8465

42081 W 14 Mile Rd
Novi, MI 48377
Phone (248) 301-6970

1769 Washtenaw Rd
Ypsilanti, MI 48197
Phone (734) 483-2100

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1194613794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30600 W. 12 MILE RD.",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "48334",
            "telephone_number": "248-737-3937",
            "fax_number": "248-737-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1769 WASHTENAW RD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481972020",
            "telephone_number": "734-483-2100",
            "fax_number": "734-483-2060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30660 W 12 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483343808",
            "country_code": "US",
            "telephone_number": "248-310-8465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRY",
        "first_name": "LATIFA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.