Individual provider Active NPI

Sophia Avery

  • Physician Assistant
  • Rochester, NY
National Provider Identifier
1174167100
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01390 Issued in RI
Practice address
1555 Long Pond Rd
Rochester, NY 14626-4122
Phone
(585) 723-7000
NPI assigned
Nov 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 1159188 NY
Physician Assistant 363A00000X PA01390 RI Primary

Addresses

Primary practice location

1555 Long Pond Rd
Rochester, NY 14626-4122

Mailing address

7469 W Ridge Rd
Brockport, NY 14420-9429
Phone (585) 331-3143

Other practice location 1

200 High Service Ave
N Providence, RI 02904-5113
Phone (401) 456-3000

Other practice location 2

825 Chalkstone Ave
Providence, RI 02908-4728
Phone (401) 456-2000

Other practice location 3

70 Kenyon Ave Unit 325
Wakefield, RI 02879-4253
Phone (401) 284-1212

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191216001169 NY Practitioner - Physician Assistant 6103250691 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Community Medical, PCGroup PAC ID 0143238782, 153 clinicians

Practice addresses (Care Compare)

4900 Broad Rd
Syracuse, NY 13215-2265

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1159188NYMDObstetrics & Gynecology Physician
PA01390RIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Unity Hospital of Rochester CurrentSince Dec 31, 2019 Accepting new patients
Western New York Medical Practice P.C CurrentSince Dec 31, 2019 Accepting new patients
Rochester General Hospital CurrentSince Dec 31, 2019 Accepting new patients
Western New York Medical Practice P.C. CurrentSince Dec 31, 2019 Accepting new patients

Locations

2 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1472

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

Interoperability endpoints

  • Direct secure messaging: savery144817@direct.upstate.edu

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1572652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1174167100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7469 W RIDGE RD",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144209429",
            "telephone_number": "585-331-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 LONG POND RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264122",
            "telephone_number": "585-723-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 High Service Ave",
            "address_purpose": "LOCATION",
            "city": "N Providence",
            "state": "RI",
            "postal_code": "029045113",
            "country_code": "US",
            "telephone_number": "401-456-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "825 Chalkstone Ave",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029084728",
            "country_code": "US",
            "telephone_number": "401-456-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "70 Kenyon Ave Unit 325",
            "address_purpose": "LOCATION",
            "city": "Wakefield",
            "state": "RI",
            "postal_code": "028794253",
            "country_code": "US",
            "telephone_number": "401-284-1212",
            "fax_number": "401-789-1358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AVERY",
        "first_name": "SOPHIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-02",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "1159188",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.