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

Sophia Avery

Individual provider Obstetrics & Gynecology Physician · NPI 1174167100

Sophia Avery is a Physician Assistant in Rochester, New York. Qualified in 2019, 7 years ago. Practices with Upstate Community Medical, PC, a 152-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in New York and Rhode Island.

Years since qualifying
7
Licensed in
NY, RI
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

1555 Long Pond Rd
Rochester, NY 14626-4122
Phone: (585) 723-7000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 200 High Service Ave, N Providence, RI 02904-5113 — (401) 456-3000
  • 825 Chalkstone Ave, Providence, RI 02908-4728 — (401) 456-2000
  • 70 Kenyon Ave Unit 325, Wakefield, RI 02879-4253 — (401) 284-1212

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA01390 (RI)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 1159188 (NY)

Record details

NPI number1174167100
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 2, 2019
Last updated in NPPESAugust 3, 2026
Certification dateAugust 3, 2026
Mailing address7469 W Ridge Rd, Brockport, NY 14420-9429

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Upstate Community Medical, Pc — 152 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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