Sandra H Bispo, MD
Individual provider Active NPI Pediatrics Physician · Sewell, NJ
NPI 1194803296 · NPPES record last updated Feb 9, 2026
Key facts
- NPI
- 1194803296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- MAO6884500 (NJ)
- Practice address
- 405 Hurffville Crosskeys Rd Ste 203
Sewell, NJ 08080-9344 - Phone
- (856) 582-0033
- Fax
- (856) 582-2305
- NPI assigned
- Nov 2, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- Other, 1995
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
303 Lippincott Dr
Suite 200
Marlton, NJ 08053-4160
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251119004129 | NJ | Practitioner - Pediatric Medicine | 0749283968 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A85923 | CA | MD | Pediatrics Physician |
| MAO6884500 | NJ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virtua Medical Group, PA | Current |
Accepting new patients | |
| Virtua Medical Group, PA | Current |
Accepting new patients | |
| Pediatric Associates LLC | Pediatrics | Past | Accepting new patients |
| Inspira Medical Centers, Inc. | Past | Accepting new patients | |
| Virtua Medical Group, PA | Past | Accepting new patients |
Locations
3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340
141 Route 70 E
Ste E
Marlton, NJ 08053
Phone (856) 985-7373
301 Lippincott Dr
Ste 410
Marlton, NJ 08053
1474 Tanyard Rd
Ste D102
Sewell, NJ 08080
Phone (856) 566-7045
405 Hurffville Crosskeys Rd
Ste 203
Sewell, NJ 08080
Phone (856) 582-0033
Interoperability endpoints
- sandra.bispo@pedassoc.eclinicaldirectplus.com
- sbispo319769@directvirtua.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A85923 | CA | |
| Pediatrics Physician | 208000000X | MAO6884500 | NJ | Yes |
Addresses
Primary practice location
405 Hurffville Crosskeys Rd Ste 203
Sewell, NJ 08080-9344
Mailing address
301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 582-0033
Other practice location 1
42 E Laurel Rd Ste 3500
Stratford, NJ 08084-1354
Phone (856) 566-7040
Other practice location 2
1318 S Main Road
Vineland, NJ 08360
Phone (856) 691-8585
Other practice location 3
1474 Tanyard Rd Ste D102
Sewell, NJ 08080-4222
Phone (856) 566-7045
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0031071 | Medicaid | NJ |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sbispo319769@directvirtua.org |
Other providers in Sewell, NJ
- James R Bertel
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- Nicholas Andrew Bianco
- Carl Angelo Bifano
- Daniel Bigini
- Ellen Louise Bleidorn
- Edward Andrew Bley Jr.
- Craig Bober
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- Michele Boggs
All providers in Sewell, NJ · Pediatrics Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.