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

JORDAN WIEBE DO
NPI 1215590831
Surgery - Plastic and Reconstructive Surgery in Phoenix, AZ

Q: What is Jordan Wiebe's NPI number?

The NPI number for Jordan Wiebe is 1215590831. It was assigned to this individual provider in the NPPES registry on April 18, 2019.

Q: What is Jordan Wiebe's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Q: When was this NPI record last updated?

The NPPES record for Jordan Wiebe was last updated on July 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since April 18, 2019PECOS Enrolled

2801 E CAMELBACK RD STE 100, PHOENIX, AZ 85016(480) 680-9903 Get Directions Write a Review

NPPES record last updated: July 30, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 30, 2026, May 14, 2025, Apr 18, 2019 (3 updates tracked since 2019).

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About Jordan Wiebe Do NPPES

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

JORDAN WIEBE DO (NPI 1215590831) is an individual plastic and reconstructive surgery provider in Phoenix, Arizona, licensed in Arizona (012361) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS and is a graduate of Oklahoma State University College Of Osteopathic Medicine (2019).

NPPES Registry Identity

NPI1215590831

Entity TypeIndividualFemale

Primary Taxonomy2086S0122X

Provider Legal NameJORDAN WIEBECredential: DO

Location Address2801 E CAMELBACK RD STE 100Phoenix, AZ 85016-4363

Mailing Address2801 E Camelback RdPhoenix, AZ 85016-4363 · (480) 680-9903

Phone(480) 680-9903

Sole ProprietorYes

Medical School CMSOklahoma State University College Of Osteopathic MedicineGraduated 2019

Enumeration DateApril 18, 2019

Last NPPES UpdateJuly 30, 20263 updates tracked since enumeration

NPPES CertifiedJuly 30, 2026

✔ NPI 1215590831 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0122X

Licenses✔ Licensed in AZ · 012361✔ Licensed in CT · 80521

Definition

A surgeon who specializes in plastic and reconstructive surgery.

2801 E CAMELBACK RD STE 100, Phoenix, AZ 85016

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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)

Jordan Wiebe Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9537492236

PECOS Enrollment IDI20250806001084

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.

Other Providers at the Same Location NPPES 9

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

BEAUTY EDIT

Specialist/Technologist, Other