National Provider Identifier (NPI) Application and Update Form and Supporting Regs in 45 CFR 142.408, 45 CFR 162.408, 45 CFR 162.406 (CMS-10114)

ICR 201512-0938-003

OMB: 0938-0931

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Form and Instruction
Modified
Justification for No Material/Nonsubstantive Change
2015-12-11
Supplementary Document
2015-01-16
Supporting Statement A
2015-01-16
ICR Details
0938-0931 201512-0938-003
Historical Active 201501-0938-005
HHS/CMS
National Provider Identifier (NPI) Application and Update Form and Supporting Regs in 45 CFR 142.408, 45 CFR 162.408, 45 CFR 162.406 (CMS-10114)
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved with change 10/18/2016
Retrieve Notice of Action (NOA) 12/11/2015
  Inventory as of this Action Requested Previously Approved
03/31/2018 03/31/2018 03/31/2018
608,880 0 608,880
202,960 0 202,960
0 0 0

The National Provider Identifier (NPI) Application and Update Form is used by health care providers to apply for NPIs and furnish updates to the information they supplied on their initial applications. The form is also used to deactivate their NPIs if necessary. The form is available on paper or can be completed via a web-based process. An NPI is expected to last for the "life" of the health care provider (i.e., until the death of an individual or until the dissolution of an organization); therefore, a health care provider applies for an NPI only one time. A health care provider must furnish updates to the required information given in the application whenever changes occur to those data. Updates can be mailed or submitted electronically.

None
None

Not associated with rulemaking

  79 FR 54725 09/12/2014
79 FR 2429 01/16/2015
No

2
IC Title Form No. Form Name
National Provider Identifier (NPI) Application and Update Form CMS-10114 NPI Application and Update Form
National Provider Identifier (NPI) Application CMS-10114 NPI Application

  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 608,880 608,880 0 0 0 0
Annual Time Burden (Hours) 202,960 202,960 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
No
No
No
Uncollected
Jamaa Hill 301 492-4190

  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.
12/11/2015


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