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LAKESHORE ENT
NPI 1003096991
Otolaryngology - Facial Plastic Surgery in Granbury, TX

Active since November 07, 2007
1305 PALUXY RD, SUITE A, GRANBURY, TX 76048(817) 573-6673(817) 573-9783 Get Directions Write a Review

NPPES record last updated: August 15, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Lakeshore Ent NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKESHORE ENT (NPI 1003096991) is a healthcare organization registered as a facial plastic surgery in Granbury, Texas and active in the NPI registry since November 2007. The organization lists Stephen George Krzeminski, Owner, as its authorized official.

NPPES Registry Identity

NPI1003096991
Entity TypeOrganization
Primary Taxonomy207YS0123X
Legal Business NameLAKESHORE ENT
Location Address1305 PALUXY RD, SUITE AGranbury, TX 76048-5641
Mailing Address1305 Paluxy Rd, Suite AGranbury, TX 76048-5641 · (817) 573-6673 · Fax (817) 573-9783
Phone(817) 573-6673
Fax(817) 573-9783
Organization SubpartNo
Authorized OfficialStephen George KrzeminskiOwner · (817) 573-6673
Enumeration DateNovember 7, 2007
Last NPPES UpdateAugust 15, 2025
NPPES CertifiedAugust 15, 2025
✔ NPI 1003096991 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngology · Facial Plastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207YS0123X
License✔ Licensed in TX · K8272
Definition
An otolaryngologist who specializes in facial plastic surgery.
1305 PALUXY RD, Granbury, TX 76048
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include WellPoint.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lakeshore Ent is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Lakeshore Ent, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Stephen Krzeminski, D.O.
Otolaryngology
NPI 1992783393
1305 PALUXY RD SUITE A
Granbury, TX 76048
(817) 573-6673
✔ PECOS✔ Accepts MedicareSame address
Jennifer Winkle, AU.D.,CCC-A
Qualified Audiologist
NPI 1285885830
1305 PALUXY RD SUITE A
Granbury, TX 76048
(817) 573-6673
✔ Accepts MedicareSame address
Jessica Tryon, FNP-C
Nurse Practitioner
NPI 1376295220
626 BILLINGS RD
Tolar, TX 76476
(817) 776-6115
✔ PECOS✔ Accepts Medicare5.9 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lakeshore Ent's NPI number?

The NPI number for Lakeshore Ent is 1003096991. It was assigned to this organization in the NPPES registry on November 7, 2007.

Where is Lakeshore Ent located?

Lakeshore Ent is located at 1305 Paluxy Rd Suite A, Granbury, TX 76048. The listed phone number is (817) 573-6673.

What is Lakeshore Ent's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Facial Plastic Surgery, with taxonomy code 207YS0123X.

Is Lakeshore Ent enrolled in Medicare?

Yes. Lakeshore Ent is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lakeshore Ent?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Lakeshore Ent, in Nurse Practitioner, Otolaryngology and Qualified Audiologist. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Lakeshore Ent accept?

Health plans from WellPoint list Lakeshore Ent as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lakeshore Ent was last updated on August 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.