Joyce Boluwatife Idehen, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

W2077 Issued in TX

Practice address

10905 Memorial Hermann Dr Ste 130
Pearland, TX 77584-3773

Phone

(346) 288-8746

Fax

(346) 200-3841

NPI assigned

Jun 12, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Joyce Boluwatife Sadiku Former name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clear Lake Primary Care PLLCGroup PAC ID 6406001627, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jidehen690859@direct.ochin.org
• FHIR API: https://fhir4.healow.com/fhir/r4/CFFDBA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clear Lake Primary Care PLLC

  • Family Medicine Physician
  • Webster, TX
  • NPI 1861743247
  Medicare reassignment Care Compare group NPD
• CLS Health PLLC

  • Infectious Disease Physician
  • Webster, TX
  • NPI 1750305355
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1215420559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57845",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775987845",
            "telephone_number": "346-288-8746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10905 MEMORIAL HERMANN DR STE 130",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775843773",
            "telephone_number": "346-288-8746",
            "fax_number": "346-200-3841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 N Kobayashi Ste F",
            "address_purpose": "LOCATION",
            "city": "Webster",
            "state": "TX",
            "postal_code": "775984722",
            "country_code": "US",
            "telephone_number": "281-816-3092",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 N Kobayashi Ste 309",
            "address_purpose": "LOCATION",
            "city": "Webster",
            "state": "TX",
            "postal_code": "775984841",
            "country_code": "US",
            "telephone_number": "281-724-8332",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 N Kobayashi Ste 110",
            "address_purpose": "LOCATION",
            "city": "Webster",
            "state": "TX",
            "postal_code": "775984841",
            "country_code": "US",
            "telephone_number": "281-338-1701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IDEHEN",
        "first_name": "JOYCE",
        "middle_name": "BOLUWATIFE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "865223",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "W2077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOYCE",
            "last_name": "SADIKU",
            "middle_name": "BOLUWATIFE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Prince Ikenna Ibe
• Nneoma Ibezim
• Icare Medical Systems LLC
• Iconic Smiles
• Ideal Dental of Pearland PLLC
• Oluwakemi Idowu
• Eberenne F Igbokwe, D.O.
• Judith Ihediwa
• Nurfaidja Jilhano Ijiran, PT
• Ilacone Group Incorporated

• Family Medicine Physician in Pearland, TX
• Providers in Pearland, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.