Robert A Decolli Jr., D.O

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4200 Issued in TN

Practice address

3360 N Watkins St
Memphis, TN 38127-6405

Phone

(901) 401-7150

Fax

(901) 347-1285

NPI assigned

Aug 24, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA, VA, TN3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Internal Medicine

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osh Mi Physicians Group, PCGroup PAC ID 7810282191, 154 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: robert.decolli.1@20250.direct.athenahealth.com

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

• Osh Mi Physicians Group, PC

  • Primary Care Clinic/Center
  • Memphis, TN
  • NPI 1720635790
  Medicare reassignment Care Compare group NPD
• Memphis Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Memphis, TN
  • NPI 1144236902
  Medicare reassignment NPD
• Dedicated Physicians Group of Tennessee, PLLC

  • Non-Pharmacy Dispensing Site
  • Miami, FL
  • NPI 1174144695

  TN

  Medicare reassignment NPD
• Schuylkill Health System Medical Group, Inc.

  • Internal Medicine Physician
  • Pottsville, PA
  • NPI 1588603567
  Medicare reassignment NPD
• Dedicated Physicians Group of Tennessee, PLLC

  • Non-Pharmacy Dispensing Site
  • Memphis, TN
  • NPI 1922634575
  NPD
• Memphis Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Memphis, TN
  • NPI 1659745354
  NPD
• Memphis Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Rossville, TN
  • NPI 1760780969
  NPD
• Oak Street Health Physicians Group of Tennessee, PLLC

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1760116172
  NPD
• PMR Virginia Holding, LLC

  • Specialist
  • Miami Gardens, FL
  • NPI 1083167001
  NPD
• Schuylkill Health System Medical Group, Inc.

  • Emergency Medicine Physician
  • Pottsville, PA
  • NPI 1063073823

  Internal Medicine

  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Memphis, TN
  • NPI 1386709871
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1558365890
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Germantown, TN
  • NPI 1649654450
  Care Compare affiliation

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1790778991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746725",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746725",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3360 N WATKINS ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381276405",
            "telephone_number": "901-401-7150",
            "fax_number": "901-347-1285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECOLLI",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "4200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015039900003",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110104720",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ian Robert Decareaux, PHARMD
• Donald Patsy Decarlo Jr., MD
• Sorawit Timothy Decha-Umphai, M.D.
• Waraporn Decha-Umphai, BSC (PHARMACY), MSC
• Robert Decolli III, CRNP
• Amanda Maxwell Decrow, PHD
• Paula Decrow, FNP
• Dedicated Physicians Group of Tennessee, PLLC
• Dedicated Physicians Group of Tennessee, PLLC
• Dedicated Physicians Group of Tennessee, PLLC

• Internal Medicine Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.