Information Collection

NPPES WEB Application

IC 255147 under ICR 202509-0938-023 · OMB 0938-1427.

Documents and Forms

Document Name Document Type
Form CMS-10749 NPPES Application NPPES WEB Application Form and Instruction
CMS-10749 NPPES Application Appendix 1_NPPES_Screenshot.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NPPES WEB Application	Agency IC Tracking Number:	CPI

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 170.401

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10749	NPPES Application	Appendix 1_NPPES_Screenshot.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: SORN 09-70-0555, National Plan and Provider Enumeration System (NPPES)	FR Citation: 83 FR 6591

Number of Respondents: 543,183	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	543,183	-131,380	674,563
Annual IC Time Burden (Hours)	92,341	-22,335	114,676
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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