Ilyssa Swartout, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3612 Issued in AZ

Practice address

20779 W San Miguel Ave
Buckeye, AZ 85396-4609

Phone

(602) 980-9313

Fax

(602) 548-1446

NPI assigned

Jun 22, 2006

Sex

Female

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

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Growing Edges LLC

  • Clinical Psychologist
  • Buckeye, AZ
  • NPI 1073739660
  Medicare reassignment NPD Authorized official
• Wendy Chandross Cisw PC

  • Clinical Social Worker
  • Phoenix, AZ
  • NPI 1245410257
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1881630325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19580 W INDIAN SCHOOL RD STE 105-134",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853962081",
            "telephone_number": "602-548-1444",
            "fax_number": "602-548-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20779 W SAN MIGUEL AVE",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853964609",
            "telephone_number": "602-980-9313",
            "fax_number": "602-548-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWARTOUT",
        "first_name": "ILYSSA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sunshine Optometry of Arizona LLC
• Superior Medical Transportation LLC
• Sympathetic Arms Home Care
• Zenobia Adi Tamboli, DDS
• Camaria E Tapia, FNP-C
• Dace Tapley
• Emily A Tarr

• Clinical Psychologist in Buckeye, AZ
• Providers in Buckeye, AZ by specialty
• Clinical Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.