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SAPNA BALWANI
NPI 1003228339
Obstetrics & Gynecology in Willingboro, NJ

Active since May 21, 2014PECOS EnrolledAccepts Medicare Assignment
95.77/100
CMS Quality Rating
220 SUNSET RD, WILLINGBORO, NJ 08046(609) 444-5681 Get Directions Write a Review

NPPES record last updated: July 7, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 7, 2025, Jun 16, 2025, Jan 8, 2025 and 2 more (5 updates tracked since 2020).

About Sapna Balwani NPPES

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

SAPNA BALWANI (NPI 1003228339) is an individual obstetrics & gynecology provider in Willingboro, New Jersey, licensed in New Jersey (25MA10292800) and active in the NPI registry since May 2014. She is enrolled in Medicare PECOS, is affiliated with West Jersey Hospital, and is a graduate of Albany Medical College Of Union University (2014).

NPPES Registry Identity

NPI1003228339
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameSAPNA BALWANI
Location Address220 SUNSET RDWillingboro, NJ 08046
Mailing Address301 Lippincott Dr Ste 410Marlton, NJ 08053-4197 · (856) 355-0340
Phone(609) 444-5681
Sole ProprietorNo
Medical School CMSAlbany Medical College Of Union UniversityGraduated 2014
Enumeration DateMay 21, 2014
Last NPPES UpdateJuly 7, 20255 updates tracked since enumeration
NPPES CertifiedJuly 7, 2025
✔ NPI 1003228339 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Licenses✔ Licensed in NJ · 25MA10292800✔ Licensed in PA · MT206671
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
220 SUNSET RD, Willingboro, NJ 08046
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.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

Sapna Balwani 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 ID3779863345
PECOS Enrollment IDI20180702001293
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

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.

Cervical or vaginal cancer screening; pelvic and clinical breast examination G0101
This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.
20 services20 patients

Hospital Affiliations CMS Care Compare 2

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

West Jersey Hospital

Acute Care Hospitals · Voorhees, NJ
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310022
Location100 Bowman DriveVoorhees, NJ 08043 · Camden County
Emergency services Birthing friendly

Virtua Mount Holly Hospital

Acute Care Hospitals · Mount Holly, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310057
Location175 Madison AveMount Holly, NJ 08060 · Burlington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08046 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
$140.34 typical visit price
range $61.59 – $185.05
Typical copayment $35.08 (range $15.39 – $46.26)
Most-billed visit code 99204
Established Patient
$76.45 typical visit price
range $20.08 – $150.98
Typical copayment $19.11 (range $5.02 – $37.74)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.77/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality76.75
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Breast Cancer Screening
87%197 patients4/55-star benchmark: 93%
Cervical Cancer Screening
97%599 patients4/55-star benchmark: 98%
Closing the Referral Loop: Receipt of Specialist Report
34%108 patients2/55-star benchmark: 87%
Colorectal Cancer Screening
55%289 patients3/55-star benchmark: 88%
Controlling High Blood Pressure
81%78 patients4/55-star benchmark: 91%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
28%32 patients4/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
89%968 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
85%39 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
50%675 patients3/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
75%713 patients4/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
41%717 patients3/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 93% · 703 patients
Patients screened: 98% · 703 patients
28%46 patients2/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RANCOCAS OBSTETRICS AND GYNECOLOGY ASSOCIATES, LLC
Obstetrics & Gynecology
220 SUNSET RD, SUITE 1B
WILLINGBORO, NJ 08046
Burlington County (609) 877-8777
LOURDES MEDICAL CENTER OF BURLINGTON COUNTY
Clinic/Center
220 SUNSET RD, SUITE 1B
WILLINGBORO, NJ 08046
Burlington County (609) 835-5204
REHABCLINICS SPT, INC.
Clinic/Center (Rehabilitation)
220 SUNSET RD, STE 5A & 5B
WILLINGBORO, NJ 08046
Burlington County (609) 835-4801
DR. ALEXANDER FORMOLOW D.P.T.
Physical Therapist
220 SUNSET RD, SUITE 5A AND B
WILLINGBORO, NJ 08046
Burlington County (609) 835-4801
KENNETH DAVID SCHULNER M.D.
Internal Medicine (Cardiovascular Disease)
220 SUNSET RD, STE 2B
WILLINGBORO, NJ 08046
Burlington County (609) 871-4487
A BETTER SOLUTION INC
Clinical Medical Laboratory
220 SUNSET RD
WILLINGBORO, NJ 08046
Burlington County (813) 928-7939
CAYLA ROSE METZMEIER WHITE
Obstetrics & Gynecology
220 SUNSET RD
WILLINGBORO, NJ 08046
Burlington County (609) 444-5680
ASHLEIGH NICHOLE TEPPER WHNP-BC
Nurse Practitioner (Women's Health)
220 SUNSET RD
WILLINGBORO, NJ 08046
Burlington County (609) 444-5680

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 Sapna Balwani's NPI number?

The NPI number for Sapna Balwani is 1003228339. It was assigned to this individual provider in the NPPES registry on May 21, 2014.

Where is Sapna Balwani located?

Sapna Balwani practices at 220 Sunset Rd, Willingboro, NJ 08046. The listed phone number is (609) 444-5681.

What is Sapna Balwani's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Sapna Balwani enrolled in Medicare?

Yes. Sapna Balwani 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 Sapna Balwani accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Sapna Balwani 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 Sapna Balwani affiliated with any hospitals?

According to CMS data, Sapna Balwani is affiliated with West Jersey Hospital and Virtua Mount Holly Hospital.

When was this NPI record last updated?

The NPPES record for Sapna Balwani was last updated on July 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.