Ian Matthew Wiersma, PA-C

Primary specialty

Trauma Surgery PhysicianTaxonomy code 2086S0127X

License

12034 Issued in AZ

Practice address

1625 N Campbell Ave
Tucson, AZ 85719-4330

Phone

(520) 694-0111

NPI assigned

Jan 20, 2025

Last updated

Sep 21, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1737331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1174335913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 4TH ST NW",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510411322",
            "telephone_number": "616-240-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194330",
            "telephone_number": "520-694-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIERSMA",
        "first_name": "IAN",
        "middle_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-20",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Trauma Surgery",
            "state": "AZ",
            "license": "12034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine A Widener, LCSW
• Ronald Joseph Widman, MD
• Nathalie Wieczorek, BCBA
• Keith Wiegand, PHARMD
• Stephanie Russell Wiegand, MSPT
• Calvin Wiese, LCSW
• Jeff D Wiese, LCSW
• Rebecca Wiese, LCSW
• Charles D Wiesel, P.A.
• Evangeline Sara Wiest, RN

• Trauma Surgery Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Trauma Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.