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LAKE GROVE ENT PC
NPI 1043211824
Otolaryngology in Lake Oswego, OR

Active since August 03, 2005
17704 JEAN WAY, STE 101, LAKE OSWEGO, OR 97035(503) 699-0370(971) 236-9099 Get Directions Write a Review

NPPES record last updated: April 4, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Lake Grove Ent Pc NPPES

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

LAKE GROVE ENT PC (NPI 1043211824) is a healthcare organization registered as an otolaryngology in Lake Oswego, Oregon and active in the NPI registry since August 2005. The organization lists Cheryl Lee Kruse, Clinic Manager, as its authorized official.

NPPES Registry Identity

NPI1043211824
Entity TypeOrganization
Primary Taxonomy207Y00000X
Legal Business NameLAKE GROVE ENT PC
Location Address17704 JEAN WAY, STE 101Lake Oswego, OR 97035-5497
Mailing Address17704 Jean Way, Ste 101Lake Oswego, OR 97035-5497 · (503) 699-0370 · Fax (971) 236-9099
Phone(503) 699-0370
Fax(971) 236-9099
Organization SubpartNo
Authorized OfficialCheryl Lee KruseClinic Manager · (503) 699-0370
Enumeration DateAugust 3, 2005
Last NPPES UpdateApril 4, 2022
NPPES CertifiedApril 4, 2022
✔ NPI 1043211824 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
17704 JEAN WAY, Lake Oswego, OR 97035
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Other Identifiers 1

Medicaid005809OR

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Oregon.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)

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

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Lake Grove Ent PC, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 6 within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Robert Furman, MD
Otolaryngology
NPI 1336145614
17704 JEAN WAY STE 101
Lake Oswego, OR 97035
(503) 699-0370
✔ PECOS✔ Accepts MedicareSame address
Erika Schettler Huberty, MD
Otolaryngology
NPI 1508963125
17704 JEAN WAY SUITE 101
Lake Oswego, OR 97035
(503) 699-0370
✔ PECOS✔ Accepts MedicareSame address
Kimberly Lavoie, MS CCCA
Qualified Audiologist
NPI 1588821409
17704 JEAN WAY SUITE 101
Lake Oswego, OR 97035
(503) 699-0370
✔ Accepts MedicareSame address
Stuti Desai, MD
Otolaryngology
NPI 1265964662
17704 JEAN WAY STE 101
Lake Oswego, OR 97035
(503) 699-0370
✔ PECOS✔ Accepts MedicareSame address
Jennifer March, MD, MS
Otolaryngology
NPI 1730556002
17704 JEAN WAY STE 101
Lake Oswego, OR 97035
(503) 278-4981
✔ PECOS✔ Accepts MedicareSame address
Caroline Yang, M.D
Otolaryngology
NPI 1194818955
9800 SE SUNNYSIDE RD.
Clackamas, OR 97015
(503) 653-6440
✔ PECOS✔ Accepts Medicare8.8 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 Lake Grove Ent PC's NPI number?

The NPI number for Lake Grove Ent PC is 1043211824. It was assigned to this organization in the NPPES registry on August 3, 2005.

Where is Lake Grove Ent PC located?

Lake Grove Ent PC is located at 17704 Jean Way Ste 101, Lake Oswego, OR 97035. The listed phone number is (503) 699-0370.

What is Lake Grove Ent PC's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Lake Grove Ent PC enrolled in Medicare?

Yes. Lake Grove Ent PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lake Grove Ent PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Lake Grove Ent PC. 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. The largest specialties are Otolaryngology (5) and Qualified Audiologist (1). Of these, 5 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Lake Grove Ent PC accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Oregon list Lake Grove Ent PC 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 Lake Grove Ent PC was last updated on April 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.