Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Robert D. Lisota, PHD

Individual provider Clinical Psychologist · NPI 1316175862

Robert D. Lisota, PHD is a Clinical Psychologist in Idaho Falls, Idaho. Qualified in 2007, 19 years ago. Practices with Pearl Health Clinic, a 38-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
19
Licensed in
ID
In the registry since
2009
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

725 S Woodruff Ave Ste 101
Idaho Falls, ID 83401-5286
Phone: (208) 346-7500
Fax: (208) 346-7501
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY202807 (ID)

Record details

NPI number1316175862
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedJune 23, 2009
Last updated in NPPESMay 30, 2025
Certification dateMay 30, 2025
Mailing address725 S Woodruff Ave Ste 101, Idaho Falls, ID 83401-5286

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Pearl Health Clinic — 38 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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