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DR. BRENT C THIBODEAUX MD
NPI 1386705721
Pediatrics in Reston, VA

Active since December 12, 2006PECOS Enrolled
11445 SUNSET HILLS RD, KAISER PERMANENTE RESTON MEDICAL CENTER, RESTON, VA 20190(703) 709-1500(703) 709-1711 Get Directions Write a Review

NPPES record last updated: June 23, 2021. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Dr. Brent C Thibodeaux Md NPPES

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

DR. BRENT C THIBODEAUX MD (NPI 1386705721) is an individual pediatrics provider in Reston, Virginia, licensed in Virginia (0101057696) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1386705721
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. BRENT C THIBODEAUXCredential: MD
Location Address11445 SUNSET HILLS RD, KAISER PERMANENTE RESTON MEDICAL CENTERReston, VA 20190-5276
Mailing Address2101 E Jefferson St, Kaiser Permanente Medicare EnrollmentRockville, MD 20852-4908 · (301) 816-2424
Phone(703) 709-1500
Fax(703) 709-1711
Sole ProprietorNo
Enumeration DateDecember 12, 2006
Last NPPES UpdateJune 23, 2021
NPPES CertifiedJune 23, 2021
✔ NPI 1386705721 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in VA · 0101057696✔ Licensed in DC · MD034757✔ Licensed in MD · D61216
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
11445 SUNSET HILLS RD, Reston, VA 20190
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Brent C Thibodeaux Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20190 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. YVETTE ROBERSON M.D.
Internal Medicine
11445 SUNSET HILLS RD
RESTON, VA 20190
Fairfax County (703) 709-1500
MRS. ANN SUNDARESAN LCSW
Social Worker (Clinical)
11445 SUNSET HILLS RD
RESTON, VA 20190
Fairfax County (703) 709-1650
DR. WANDA M PATTERSON M.D.
Dermatology
11445 SUNSET HILLS RD, KAISER PERMANENTE RESTON MEDICAL CENTER
RESTON, VA 20190
Fairfax County (703) 709-1550
DR. DANIEL G KAW M.D.
Internal Medicine
11445 SUNSET HILLS RD
RESTON, VA 20190
Fairfax County (703) 709-1500
AMY DANIELS THOMPSON MD
Internal Medicine
11445 SUNSET HILLS RD
RESTON, VA 20190
Fairfax County (703) 709-1600
WON SOOK HONG R.PH.
Pharmacist
11445 SUNSET HILLS RD
RESTON, VA 20190
Fairfax County (703) 709-1700
THUAN NGUYEN
Internal Medicine
11445 SUNSET HILLS RD
RESTON, VA 20190
Fairfax County (703) 709-1500
MS. MIHI J. PARK PHARMD
Pharmacist
11445 SUNSET HILLS RD, SUITE 300
RESTON, VA 20190
Fairfax County (703) 709-1700

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 Brent Thibodeaux's NPI number?

The NPI number for Brent Thibodeaux is 1386705721. It was assigned to this individual provider in the NPPES registry on December 12, 2006.

Where is Brent Thibodeaux located?

Brent Thibodeaux practices at 11445 Sunset Hills Rd Kaiser Permanente Reston Medical Center, Reston, VA 20190. The listed phone number is (703) 709-1500.

What is Brent Thibodeaux's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Brent Thibodeaux enrolled in Medicare?

Yes. Brent Thibodeaux is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Brent Thibodeaux was last updated on June 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.