Information Collection

NPPES Web Application (EFI process)

IC 255148 under ICR 202509-0938-023 · OMB 0938-1427.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10749 NPPES Application NPPES Web Application (EFI process)	Form and Instruction
CMS-10749 NPPES Application Appendix 1_NPPES_Screenshot.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10749				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: 2,465

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 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	2,465	-35,936	38,401
Annual IC Time Burden (Hours)	419	-6,109	6,528
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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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