Information Collection Request

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 202011-0938-004 · OMB 0938-0931 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10114 NPI Application Form and Instruction Modified Repair queued
Form CMS-10114 National Provider Identifier (NPI) Application Form and Instruction Modified Repair queued
Form CMS-10114 NPI Application and Update Form Form and Instruction Modified Repair queued
Form CMS-10114 National Provider Identifier (NPI) Application and Update Form Form and Instruction Modified Repair queued
CMS-10114 - Supporting Statement - 30-day.docx Supporting Statement A Uploaded 2020-11-10 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
37925 National Provider Identifier (NPI) Application Form and Instruction ModifiedNPI Application
37925 National Provider Identifier (NPI) Application Form and Instruction Modified
179125 National Provider Identifier (NPI) Application and Update Form Form and Instruction ModifiedNPI Application and Update Form
179125 National Provider Identifier (NPI) Application and Update Form Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2024 36 Months From Approved 08/31/2021
996,042 0 1,418,345
169,327 0 482,238
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
National Provider Identifier (NPI) Application CMS-10114
National Provider Identifier (NPI) Application and Update Form CMS-10114

table that charts list of burden
  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 996,042 1,418,345 0 0 -422,303 0
Annual Time Burden (Hours) 169,327 482,238 0 0 -312,911 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No