Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Robert D. Lisota, PHD

Individual provider Forensic Psychologist · NPI 1316175862

Robert D. Lisota, PHD is a Clinical Psychologist in Chubbuck, 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

774 Leonidas St
Chubbuck, ID 83202-1664
Phone: (208) 220-1944
Fax: (208) 516-1569
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Forensic Psychologist (primary) Taxonomy 103TF0200X · Licence PSY202807 (ID)

Record details

NPI number1316175862
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedJune 23, 2009
Last updated in NPPESSeptember 30, 2026
Certification dateSeptember 30, 2026

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

Colleagues at Pearl Health Clinic

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 38 clinicians in the practice; 12 are shown here.