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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SIMONE ROSE THIBAULT
NPI 1700535663
Obstetrics & Gynecology in Beaverton, OR

Active since March 19, 2022PECOS Enrolled
4855 SW WESTERN AVE, BEAVERTON, OR 97005(503) 813-2000 Get Directions Write a Review

NPPES record last updated: October 20, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 11, 2026, Jul 7, 2026 (2 updates tracked since 2026).

About Simone Rose Thibault NPPES

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

SIMONE ROSE THIBAULT (NPI 1700535663) is an individual obstetrics & gynecology provider in Beaverton, Oregon, licensed in Oregon (MD231429) and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS, maintains a secondary practice location in Salem, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1700535663
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameSIMONE ROSE THIBAULT
Location Address4855 SW WESTERN AVEBeaverton, OR 97005-3460
Mailing Address500 Ne Multnomah St Ste 100, Floor 11Portland, OR 97232-2099 · (800) 813-2000
Phone(503) 813-2000
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMarch 19, 2022
Last NPPES UpdateOctober 20, 20262 updates tracked since enumeration
NPPES CertifiedOctober 20, 2026
✔ NPI 1700535663 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Licenses✔ Licensed in OR · MD231429✔ Licensed in WA · MD.MD.70157163
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
4855 SW WESTERN AVE, Beaverton, OR 97005
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Secondary Practice Location 1

Location 15125 Skyline Rd SSalem, OR 97306-9413 · Phone (800) 813-2000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Simone Rose Thibault is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4981060993
PECOS Enrollment IDI20260805000230
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.

Medicare Billing Reassignment

Medicare enrollment records show Simone Thibault reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Regents Of The Univ Of Ca
461 mi
Urogynecology and Reconstructive Pelvic Surgery
4860 Y ST
Sacramento, CA 95817
  • Reassigned Medicare billing, California enrollment
  • 2,570 clinicians in this Medicare group
NPI 1285068783 (916) 734-6483

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97005 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
$134.16 typical visit price
range $58.99 – $176.88
Typical copayment $33.54 (range $14.74 – $44.22)
Most-billed visit code 99204
Established Patient
$73.28 typical visit price
range $19.32 – $144.79
Typical copayment $18.32 (range $4.83 – $36.19)
Most-billed visit code 99213
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 20

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

MRS. RANDEEP KAUR DA
Dental Assistant
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (503) 626-4148
CHANNA V HANG PA
Physician Assistant
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (503) 813-2000
MEDHA CHUNDURU MD
Family Medicine
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (800) 813-2000
MARYLOU STRONG
Physical Therapist
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (503) 520-4950
BRADLEY RAY PLANT DPT, CSCS
Physical Therapist
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (800) 813-2000
AMANDA ANDERSEN
Internal Medicine
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (503) 813-2000
TINA TRUONG
Dental Hygienist
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (800) 213-2000
SANDRA MEACHAM REED M.D.
Obstetrics & Gynecology
4855 SW WESTERN AVE
BEAVERTON, OR 97005
Washington County (503) 643-7565

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 Simone Thibault's NPI number?

The NPI number for Simone Thibault is 1700535663. It was assigned to this individual provider in the NPPES registry on March 19, 2022.

Where is Simone Thibault located?

Simone Thibault practices at 4855 SW Western Ave, Beaverton, OR 97005. The listed phone number is (503) 813-2000.

What is Simone Thibault's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Simone Thibault enrolled in Medicare?

Yes. Simone Thibault is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Simone Thibault's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Simone Thibault reassigns Medicare benefits to Regents Of The Univ Of Ca (Sacramento, CA). The 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 Simone Thibault's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Simone Thibault was last updated on October 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 days 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.