Accepting New Patients Indicator UPIN (Unique Physician Identifi- cation Number) Participating Physicians Directory

ICR 200401-0938-001

OMB: 0938-0905

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0938-0905 200401-0938-001
Historical Active 200307-0938-006
HHS/CMS
Accepting New Patients Indicator UPIN (Unique Physician Identifi- cation Number) Participating Physicians Directory
Extension without change of a currently approved collection   No
Regular
Approved without change 03/02/2004
Retrieve Notice of Action (NOA) 01/06/2004
  Inventory as of this Action Requested Previously Approved
03/31/2007 03/31/2007 03/31/2004
10,980 0 10,980
915 0 915
0 0 0

In November of 2000, CMS launched the Participating Physicians Directory on www.medicare.gov. This particular directory was created to provide beneficiaries with the names, addresses, and specialties of Medicare participating physicians who have agreed to accept assignment on all Medicare claims and covered services. CMS is adding information from already existing sources; in addition CMS wants to collect a new data element "Accepting New Patients Indicator" which is essential to a beneficiary's search for a physician.

None
None


No

1
IC Title Form No. Form Name
Accepting New Patients Indicator UPIN (Unique Physician Identifi- cation Number) Participating Physicians Directory CMS-10091

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 10,980 10,980 0 0 0 0
Annual Time Burden (Hours) 915 915 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
01/06/2004


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