Sofia Kenneally, - Medicare Physician Assistant in Lakeport, CA

  1. Home
  2. Physician Assistant
  3. CA
  4. Lakeport
Sofia Kenneally, is a medicare enrolled "Physician Assistant" in Lakeport, California. She graduated from nursing school in 2021 and has 5 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Providence Medical Foundation, Sutter Bay Medical Foundation and her current practice location is 5176 Hill Rd E, Lakeport, California. You can reach out to her office (for appointments etc.) via phone at (707) 262-5000.

Sofia Kenneally is licensed to practice in California (license number PA60896) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1528718327.

Contact Information

Sofia Kenneally,
5176 Hill Rd E,
Lakeport, CA 95453-6300
(707) 262-5000
Not Available

Map and Direction




Provider's Profile

Full NameSofia Kenneally
GenderFemale
SpecialityPhysician Assistant
Experience5 Years
Location5176 Hill Rd E, Lakeport, California
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Sofia Kenneally graduated from nursing school in 2021
  NPI Data:
  • NPI Number: 1528718327
  • Provider Enumeration Date: 03/25/2022
  • Last Update Date: 10/24/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 8022497106
  • Enrollment ID: I20220621000419

Medical Identifiers

Medical identifiers for Sofia Kenneally such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1528718327NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant PA60896 (California)Primary
207P00000XEmergency Medicine 60896 (California)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Providence Santa Rosa Memorial HospitalSanta rosa, CAHospital
Providence Queen Of The Valley Medical CenterNapa, CAHospital
Sutter Santa Rosa Regional HospitalSanta rosa, CAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Providence Medical Foundation89219932051461
Sutter Bay Medical Foundation42845387783783

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Sofia Kenneally allows following entities to bill medicare on her behalf.
Entity NameSutter Bay Medical Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013950807
PECOS PAC ID: 4284538778
Enrollment ID: O20031125000909
Entity NameProvidence Medical Foundation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1871607762
PECOS PAC ID: 8921993205
Enrollment ID: O20040216001346
Entity NameSan Francisco Emergency Medical Associates
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1134110661
PECOS PAC ID: 5698662518
Enrollment ID: O20040303001130
Entity NameNapa Valley Emergency Medical Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1467463539
PECOS PAC ID: 5698664977
Enrollment ID: O20040419000856
Entity NameSutter Bay Medical Foundation
Entity TypePart B Supplier - Ambulatory Surgical Center
Entity IdentifiersNPI Number: 1982845186
PECOS PAC ID: 4284538778
Enrollment ID: O20090501000247
Entity NameSutter Bay Medical Foundation
Entity TypePart B Supplier - Ambulatory Surgical Center
Entity IdentifiersNPI Number: 1104067115
PECOS PAC ID: 4284538778
Enrollment ID: O20090501000456
Entity NameSutter Bay Medical Foundation
Entity TypePart B Supplier - Ambulatory Surgical Center
Entity IdentifiersNPI Number: 1497996524
PECOS PAC ID: 4284538778
Enrollment ID: O20090506000097
Entity NameSutter Bay Medical Foundation
Entity TypePart B Supplier - Ambulatory Surgical Center
Entity IdentifiersNPI Number: 1568851327
PECOS PAC ID: 4284538778
Enrollment ID: O20170927001545
Entity NameSutter Bay Medical Foundation
Entity TypePart B Supplier - Ambulatory Surgical Center
Entity IdentifiersNPI Number: 1033817168
PECOS PAC ID: 4284538778
Enrollment ID: O20230407001373

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Sofia Kenneally is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Sofia Kenneally,
Po Box 2741,
Petaluma, CA 94953-2741

Ph: (415) 847-4867		Sofia Kenneally,
5176 Hill Rd E,
Lakeport, CA 95453-6300

Ph: (707) 262-5000

Reviews and Comments


Physician Assistant Nurses in Lakeport, CA

Ms. Nichol Ann Kriz, PA-C
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 5176 Hill Road East, Lakeport, CA 95453
Phone: 707-262-5000    
Jayla Flaum, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 987 Parallel Dr Ste C, Lakeport, CA 95453
Phone: 707-262-5088    
Erin E Thurman, PA
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 5150 Hill Rd E Ste E, Lakeport, CA 95453
Phone: 707-263-4360    Fax: 707-263-4036
Amanda L Smithers, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 5196 Hill Rd E Ste 300, Lakeport, CA 95453
Phone: 707-263-6885    
Christine Anne Goold, FNP/PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 5144 Hill Rd E, Lakeport, CA 95453
Phone: 707-263-8955    Fax: 707-263-8340
Jaques Ngakam, PA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 801 11th St, Lakeport, CA 95453
Phone: 707-263-3746    Fax: 707-263-3749
Kimberly Austin Kirschner, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 5196 Hill Rd E Ste 300, Lakeport, CA 95453
Phone: 707-263-6885    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.