Sofia Kenneally, - Medicare Emergency Medicine in Lakeport, CA

Sofia Kenneally, is a medicare enrolled "Emergency Medicine" physician in Lakeport, California. 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 60896) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1528718327.

Contact Information

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



Physician's Profile

Full NameSofia Kenneally
GenderFemale
SpecialityEmergency Medicine
Location5176 Hill Rd E, Lakeport, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1528718327
  • Provider Enumeration Date: 03/25/2022
  • Last Update Date: 03/25/2022
  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
207P00000XEmergency Medicine 60896 (California)Primary

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

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› Verified 6 days ago


Emergency Medicine Doctors in Lakeport, CA

Christian Hackshaw, M.D.
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 5176 Hill Rd E, Emergency Department, Lakeport, CA 95453
Phone: 707-262-5050    Fax: 707-262-5053
Edward M. Fedun, MD
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 5176 Hill Road E., Lakeport, CA 95453
Phone: 707-262-5000    

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