Lake Grove Ent PC
NPI 1043211824 · Otolaryngology Physician · Lake Oswego, OR
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lake Grove Ent PC is a Otolaryngology Physician organization in Lake Oswego, OR (NPI 1043211824).
Provider details
- NPI number
- 1043211824
- Entity type
- Organization
- Primary specialty
- Otolaryngology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Cheryl Kruse, Clinic Manager(503) 699-0370
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2005-08-03
- Last updated
- 2022-04-04
- Certified
- 2022-04-04
Frequently asked questions
- What is Lake Grove Ent PC's NPI number?
- Lake Grove Ent PC's National Provider Identifier (NPI) is 1043211824, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lake Grove Ent PC?
- Lake Grove Ent PC is classified in the NPPES registry as Otolaryngology Physician (Allopathic & Osteopathic Physicians).
- Where is Lake Grove Ent PC located?
- Lake Grove Ent PC's practice location on file with NPPES is 17704 Jean Way, Lake Oswego, OR 97035-5497.
- What is Lake Grove Ent PC's phone number?
- The practice phone number listed in the NPPES registry for Lake Grove Ent PC is (503) 699-0370.
- Does Lake Grove Ent PC accept Medicare?
- Lake Grove Ent PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Lake Grove Ent PC?
- The authorized official listed on Lake Grove Ent PC's NPPES record is Cheryl Kruse, Clinic Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lake Grove Ent PC's NPI active?
- Yes — Lake Grove Ent PC's NPI (1043211824) is active in the NPPES registry as of the last update on 2022-04-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.