Robert D. Lisota, PH.D.
NPI 1316175862ActiveIndividual· Psychologist, Forensic· Chubbuck, ID
Psychologist, Forensic (PH.D.) with Pearl Health Clinic, practicing in Chubbuck, Idaho. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1316175862 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PH.D. |
| Sole proprietor | Yes |
| NPI issued | Jun 23, 2009 |
| Last updated in NPPES | Sep 30, 2026 |
| Certified by provider | Sep 30, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Forensic Primary | 103TF0200X | PSY202807 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (ID) |
|---|
Education and affiliations
| Graduation year | 2007 |
|---|---|
| Medicare specialty | Clinical Psychologist |
Medical group
- Pearl Health ClinicAmmon, ID · 38 clinicians