OMB control number

National Plan and Provider Enumeration System (NPPES) Supplemental Data Collection (CMS-10749)

OMB 0938-1427 · HHS/CMS.

OMB 0938-1427

The National Provider Identifier 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 original application form was approved in February 2005 and has been in use since May 23, 2005. The form is available on paper or can be completed via a web-based process. Health care providers can mail a paper application, complete the application via the web-based process via the National Plan and Provider Enumeration System (NPPES), or have a trusted organization submit the application on their behalf via the Electronic File Interchange (EFI) process. The Enumerator uses the NPPES to process the application and generate the NPI. NPPES is the Medicare contractor tasked with issuing NPIs, and maintaining and storing NPI data. The National Provider Identifier (NPI) Application processes over 1 million new provider and/or updates to existing application annually.

The latest form for National Plan and Provider Enumeration System (NPPES) Supplemental Data Collection (CMS-10749) expires 2029-04-30 and can be found here.

Latest Forms, Documents, and Supporting Material
Document
Name
Form and Instruction
Form CMS-10749 NPPES Application (document unavailable)
Form and Instruction
CMS-10749 NPPES Supplemental Supporting Statement Part A REDLINE_3.30.26.pdf (document unavailable)
Supplementary Document
CMS10749Crosswalk.pdf (document unavailable)
Supplementary Document
Supporting Statement A
OMB Details

NPPES WEB Application

Federal Enterprise Architecture: Health - Health Care Services

Form CMS-10749NPPES ApplicationFillable FileableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.