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DR. SIBYL MONIQUE DUNCAN M.D.
NPI 1912238023
Family Medicine in Lithonia, GA

Active since January 29, 2010PECOS EnrolledAccepts Medicare Assignment
6000 HILLANDALE DR STE 100, LITHONIA, GA 30058(678) 418-1964(404) 592-2042 Get Directions Write a Review

NPPES record last updated: November 6, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 6, 2023, May 17, 2018 (2 updates tracked since 2018).

About Dr. Sibyl Monique Duncan M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SIBYL MONIQUE DUNCAN M.D. (NPI 1912238023) is an individual family medicine provider in Lithonia, Georgia, licensed in Georgia (79439) and active in the NPI registry since January 2010. She is enrolled in Medicare PECOS, is affiliated with Emory Decatur Hospital, and is a graduate of Howard University College Of Medicine (2009).

NPPES Registry Identity

NPI1912238023
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SIBYL MONIQUE DUNCANCredential: M.D.
Location Address6000 HILLANDALE DR STE 100Lithonia, GA 30058
Mailing Address6000 Hillandale Dr Ste 100Lithonia, GA 30058-4860 · (678) 418-2120
Phone(678) 418-1964
Fax(404) 592-2042
Sole ProprietorNo
Medical School CMSHoward University College Of MedicineGraduated 2009
Enumeration DateJanuary 29, 2010
Last NPPES UpdateNovember 6, 20232 updates tracked since enumeration
NPPES CertifiedNovember 6, 2023
✔ NPI 1912238023 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in GA · 79439
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
6000 HILLANDALE DR STE 100, Lithonia, GA 30058
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Sibyl Monique Duncan M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7113163411
PECOS Enrollment IDI20190905003545
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
152 services92 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
47 services47 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
33 services25 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
26 services25 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
18 services18 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
17 services16 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Emory Decatur Hospital

Acute Care Hospitals · Decatur, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110076
Location2701 N Decatur RoadDecatur, GA 30033 · De Kalb County
Emergency services Birthing friendly

Northside Hospital

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110161
Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County
Birthing friendly

Emory Hillandale Hospital

Acute Care Hospitals · Lithonia, GA
1/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110226
Location2801 Dekalb Medical ParkwayLithonia, GA 30058 · De Kalb County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30058 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sibyl Duncan's NPI number?

The NPI number for Sibyl Duncan is 1912238023. It was assigned to this individual provider in the NPPES registry on January 29, 2010.

Where is Sibyl Duncan located?

Sibyl Duncan practices at 6000 Hillandale Dr Ste 100, Lithonia, GA 30058. The listed phone number is (678) 418-1964.

What is Sibyl Duncan's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sibyl Duncan enrolled in Medicare?

Yes. Sibyl Duncan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Sibyl Duncan accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Sibyl Duncan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Sibyl Duncan affiliated with any hospitals?

According to CMS data, Sibyl Duncan is affiliated with Emory Decatur Hospital, Northside Hospital and Emory Hillandale Hospital.

When was this NPI record last updated?

The NPPES record for Sibyl Duncan was last updated on November 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.