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JOSE FERNANDO PAREJA ZABALA
NPI 1407389414
Family Medicine - Sleep Medicine in Delafield, WI

Active since April 06, 2017PECOS EnrolledAccepts Medicare Assignment
2301 SUN VALLEY DR, DELAFIELD, WI 53018(262) 928-4043 Get Directions Write a Review

NPPES record last updated: September 5, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 5, 2023, Nov 2, 2021 (2 updates tracked since 2021).

About Jose Fernando Pareja Zabala NPPES

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

JOSE FERNANDO PAREJA ZABALA (NPI 1407389414) is an individual sleep medicine provider in Delafield, Wisconsin, licensed in Wisconsin (75540) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, is affiliated with Waukesha Memorial Hospital, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1407389414
Entity TypeIndividualMale
Primary Taxonomy207QS1201X
Provider Legal NameJOSE FERNANDO PAREJA ZABALA
Location Address2301 SUN VALLEY DRDelafield, WI 53018-2318
Mailing Address2301 Sun Valley DrDelafield, WI 53018-2318 · (262) 928-4043
Phone(262) 928-4043
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateApril 6, 2017
Last NPPES UpdateSeptember 5, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 5, 2023
✔ NPI 1407389414 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Sleep MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS1201X
License✔ Licensed in WI · 75540
Definition
A Family Medicine Physician who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
2301 SUN VALLEY DR, Delafield, WI 53018
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Dean Health Plan, Network Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jose Fernando Pareja Zabala 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 ID9133524358
PECOS Enrollment IDI20210825002601
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.

Medicare Billing Reassignment

Medicare enrollment records show Jose Pareja Zabala reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Prohealth Medical Group Inc
0.4 mi
Internal Medicine
2750 GOLF ROAD
Delafield, WI 53018
  • Reassigned Medicare billing, Wisconsin enrollment
  • 528 clinicians in this Medicare group
NPI 1962543751 (262) 928-4900

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.
344 services260 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
108 services108 patients
Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811
A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.
47 services46 patients
Sleep study in sleep lab (6 years or older) 95810
A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.
44 services44 patients
Sleep study including heart rate, breathing, and sleep time 95800
A sleep study monitors your sleep patterns to evaluate your sleep quality. It records your heart rate, breathing, and actual sleep time. This information helps identify any sleep disorders, ensuring you get the rest you need for optimal health.
34 services34 patients
Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation G0399
A Home Sleep Test (HST) with a Type III Portable Monitor is an unattended test that records your breathing, heart rate, and oxygen levels during sleep. This test uses a minimum of 4 channels to monitor these parameters, helping to diagnose sleep disorders.
13 services13 patients

Hospital Affiliations CMS Care Compare

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

Waukesha Memorial Hospital

Acute Care Hospitals · Waukesha, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520008
Location725 American AveWaukesha, WI 53188 · Waukesha County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53018 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

Referred Medical Equipment & Supplies CMS DME claims 16

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
8 suppliers164 claims164 services$35.54 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
7 suppliers87 claims87 services$78.64 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
7 suppliers86 claims223 services$29.70 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
7 suppliers65 claims338 services$16.25 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
4 suppliers54 claims296 services$13.59 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
11 suppliers117 claims117 services$49.91 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

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

JENNIFER KELLY JONES LPC, MS
Counselor
2301 SUN VALLEY DR, SUITE #209
DELAFIELD, WI 53018
Waukesha County (262) 646-8288
MR. ERIC ROSS BOEHM PA-C
Physician Assistant
2301 SUN VALLEY DR
DELAFIELD, WI 53018
Waukesha County (262) 928-4043
HAVILAH A NORMINGTON RN, MSN
Clinical Nurse Specialist
2301 SUN VALLEY DR, SUITE 200
DELAFIELD, WI 53018
Waukesha County (262) 646-4162
PAMELA ANNE SCHMIDT-PECKHAM MSW, APSW
Social Worker
2301 SUN VALLEY DR, SUITE #209
DELAFIELD, WI 53018
Waukesha County (262) 646-8288

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 Jose Pareja Zabala's NPI number?

The NPI number for Jose Pareja Zabala is 1407389414. It was assigned to this individual provider in the NPPES registry on April 6, 2017.

Where is Jose Pareja Zabala located?

Jose Pareja Zabala practices at 2301 Sun Valley Dr, Delafield, WI 53018. The listed phone number is (262) 928-4043.

What is Jose Pareja Zabala's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sleep Medicine, with taxonomy code 207QS1201X.

Is Jose Pareja Zabala enrolled in Medicare?

Yes. Jose Pareja Zabala 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.

Which organization bills Medicare for Jose Pareja Zabala's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jose Pareja Zabala reassigns Medicare benefits to Prohealth Medical Group Inc (Delafield, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jose Pareja Zabala's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jose Pareja Zabala accept?

Health plans from Anthem Blue Cross and Blue Shield, Dean Health Plan, Network Health and UnitedHealthcare list Jose Pareja Zabala 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 Jose Pareja Zabala affiliated with any hospitals?

According to CMS data, Jose Pareja Zabala is affiliated with Waukesha Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Jose Pareja Zabala was last updated on September 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.