JOYCE BOLUWATIFE IDEHEN (MD) – Family Medicine Physician, NPI 1215420559

JOYCE BOLUWATIFE IDEHEN (MD) is a healthcare provider. based in Webster, Texas. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 865223 (TX). The NPI Number for JOYCE BOLUWATIFE IDEHEN (MD) is 1215420559

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
JOYCE BOLUWATIFE IDEHEN (MD)
NPI
1215420559
Phone
(346) 288-8746
Address
PO BOX 57845
Enumeration Date
12 June 2018
Last Update Date
13 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3467127020
Graduation Year
2021 (5 years ago)
PAC ID
4486146099
Group Practice PAC ID
6406001627
Professional Enrollment ID
I20251121001028
Address ID
TX775843773PE10905DRXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:7State licenses:2Digital endpointsOther names

8,705 FAMILY PRACTICE in TX

Provider Addresses for JOYCE BOLUWATIFE IDEHEN (MD)

  • PO BOX 57845

    WEBSTER, TX 775987845

    Phone: (346) 288-8746

    Type: Mailing

  • 600 N Kobayashi Ste 110

    Webster, TX 775984841

    Phone: (281) 338-1701

    Type: Location

  • 2626 MOLLY MALL

    APT# 606

    HOUSTON, TX 77054

    Phone: (713) 855-1401

    Type: Location

  • 500 N Kobayashi Ste F

    Webster, TX 775984722

    Phone: (281) 816-3092

    Type: Location

  • 600 N Kobayashi Ste 309

    Webster, TX 775984841

    Phone: (281) 724-8332

    Type: Location

  • 3860 W OGDEN AVE

    CHICAGO, IL 606232460

    Phone:

    Type: Mailing

  • 10905 MEMORIAL HERMANN DR STE 130

    PEARLAND, TX 775843773

    Phone: (346) 288-8746

    Fax: (346) 200-3841

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $19.

Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.

Last reported payment date: 2023-05-03 • Largest payer in this snapshot: Organon LLC ($19).

Total Amount

$19

General + Research + Ownership

Payments

1

Total payment records

General Amount

$19

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-05-03

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Organon LLC$19
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-11-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251121001028IFamily PracticeTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 77598)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406001627View full group profile
NameSpecialtyState
Family PracticeTX
Family PracticeTX
Family PracticeTX
Internal MedicineTX
Internal MedicineTX
Family Practice, General PracticeTX
Nurse PractitionerTX
Family PracticeTX
Family PracticeTX
Family PracticeTX

Reviews

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Frequently asked questions

Is JOYCE BOLUWATIFE IDEHEN (MD) listed with a National Provider Identifier?
Yes — JOYCE BOLUWATIFE IDEHEN (MD) has NPI 1215420559 on file in the registry.
Is there an active status for JOYCE BOLUWATIFE IDEHEN (MD)?
For scheduling context, JOYCE BOLUWATIFE IDEHEN (MD) is shown as active in the registry.
What expertise is attributed to JOYCE BOLUWATIFE IDEHEN (MD)?
JOYCE BOLUWATIFE IDEHEN (MD)'s specialty line reads Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for JOYCE BOLUWATIFE IDEHEN (MD)?
Travel planning: use Webster, Texas as the reference point for JOYCE BOLUWATIFE IDEHEN (MD), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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