DR. ROBERT TODD BENNETT (PH.D.) – Clinical Psychologist, NPI 1962490474

DR. ROBERT TODD BENNETT (PH.D.) is a healthcare provider. based in Boise, Idaho. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. PSY-411 (ID). The NPI Number for DR. ROBERT TODD BENNETT (PH.D.) is 1962490474

Main info

Male
31 Years Of Experience
Accepts Medicare Assignment
Name
DR. ROBERT TODD BENNETT (PH.D.)
NPI
1962490474
Phone
(208) 373-0790
Address
1755 WESTGATE DR
Enumeration Date
10 October 2005
Last Update Date
3 May 2011

Doctor Profile

Medical School Name
UNIVERSITY OF VERMONT COLLEGE OF MEDICINE
Secondary Phone
2083730790
Graduation Year
1995 (31 years ago)
PAC ID
1658558598
Group Practice PAC ID
6103801683
Professional Enrollment ID
I20110602000204
Address ID
ID837047176BO1755XDRXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

120 CLINICAL PSYCHOLOGIST in ID

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Provider Addresses for DR. ROBERT TODD BENNETT (PH.D.)

  • 1755, North Westgate Drive, Westgate Shopping Center, West Bench Neighborhood Association, Boise, Ada County, Idaho, 83704, United States

    SUITE 260

    BOISE, ID 837047174

    Phone: (208) 373-0790

    Fax: (208) 373-0816

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-06-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110602000204IClinical PsychologistIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83704)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6103801683View full group profile
NameSpecialtyState
Clinical PsychologistID
Clinical PsychologistID
Mental Health CounselorID
Clinical PsychologistCA
Clinical PsychologistID
Clinical PsychologistID
Clinical PsychologistID

Reviews

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Frequently asked questions

How is DR. ROBERT TODD BENNETT (PH.D.) identified in CMS data?
CMS-hosted NPPES data lists DR. ROBERT TODD BENNETT (PH.D.) with NPI 1962490474.
Does CMS list DR. ROBERT TODD BENNETT (PH.D.) as active?
Yes — DR. ROBERT TODD BENNETT (PH.D.) is active in the NPI listing used on this page.
What is DR. ROBERT TODD BENNETT (PH.D.)'s primary classification?
Clinical Psychologist is the headline specialty for DR. ROBERT TODD BENNETT (PH.D.) here. Clinical services aligned with this taxonomy classification.
What address line appears for DR. ROBERT TODD BENNETT (PH.D.)?
DR. ROBERT TODD BENNETT (PH.D.)'s geographic hint is Boise, Idaho in our summary view.
Why does DR. ROBERT TODD BENNETT (PH.D.) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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