Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Sofia Kenneally

Individual provider Emergency Medicine Physician · NPI 1528718327

Sofia Kenneally is a Physician Assistant in Lakeport, California. Qualified in 2021, 5 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

5176 Hill Rd E
Lakeport, CA 95453-6300
Phone: (707) 262-5000
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Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 55 2nd St, San Francisco, CA 94105-3491 — (415) 600-0764

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA60896 (CA)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 60896 (CA)

Record details

NPI number1528718327
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 25, 2022
Last updated in NPPESOctober 24, 2025
Certification dateOctober 24, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations8 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients224
Services billed 288 a service is one billed item, such as a visit, a test or a procedure
Average patient age71

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Payments from drug and device companies, 2025

Drug and device makers are required by federal law (the Physician Payments Sunshine Act) to report what they pay or give to clinicians, and CMS publishes the reports as Open Payments. This is the 2025 program year. A report is a record of a payment, not an allegation of anything, and many are small items such as meals. Only general payments are listed here; research payments and ownership or investment interests are reported separately by CMS and are not shown.

Food and Beverage $898 26 payments · a meal or drink at a meeting or visit, not a fee

Each amount is the sum of what companies reported for that kind of payment in 2025, rounded to the dollar. Not all of it is income to the clinician: a meal is not a fee, a charitable contribution goes to a charity, and a royalty or an acquisition payment is not a salary.

Check a report, or dispute one, at the source in CMS’s own tool, Open Payments. Corrections go through CMS’s dispute process. This site removes a home address on request and asks for no proof, because that is privacy; it will not remove an accurate payment report on request, because that is a statutory public disclosure.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician. Those with a page here are linked.

Colleagues at Providence Medical Foundation

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 1465 clinicians in the practice; 12 are shown here.

Other providers in Lakeport