Change Justification

Justification for CMS-10114 Section 3D error correction - 11182015.docx

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)

Change Justification

OMB: 0938-0931

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Nonsubstantive Change for Error Correction on the CMS 10114 (National Provider Identifier (NPI) Application/Update Form)


A National Provider Identification Number (NPI) is a unique identification number that virtually every provider in the United States healthcare industry uses for billing and administration.  CMS provides NPIs as a service to the industry, independent of Medicare or Medicaid. When a provider applies to CMS for an NPI, they must supply their taxonomy code; this has been a legislative requirement since the NPI was introduced in 2004 (45 CFR Part 162). In Section 3D (D. Provider Taxonomy Code (Provider Type/Specialty) and License Number Information) of the CMS 10114 (National Provider Identifier (NPI) Application/Update Form), the first column of information CMS requests from the provider is the provider’s taxonomy codes. There are four separate lines for the providers to write their taxonomy codes. However, CMS mistakenly titled each line with (minimally) the words “taxonomy code” without giving the provider any space to write the code on the line. This causes the provider to have to write the taxonomy codes around the words already on the application rather than giving the provider the space to write the taxonomy codes. CMS would like to correct this error by changing only the first column of Section 3D to delete the words in the first column and leave the line data field space blank, giving the provider the space needed to convey the information being asked. To this end, CMS is requesting to revise only the first column of Section 3D of the CMS 10114 form as shown below.





Corrected 1st column for CMS-10114, Section 3D – all other information (instructions, etc.,) remain the same (as shown below).

Taxonomy Code (list primary first)

Delete

License Number (if applicable)

State where issued (if applicable)


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Current CMS-10114, Section 3D:

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorKimberly McPhillips
File Modified0000-00-00
File Created2021-01-24

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