View Information Collection Request (ICR) Package
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View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0938-0931
ICR Reference No:
200703-0938-012
Status:
Historical Active
Previous ICR Reference No:
200503-0938-009
Agency/Subagency:
HHS/CMS
Agency Tracking No:
Title:
National Provider Identifier (NPI) Application and Update Form and Supporting Regs in 45 CFR 142.408, 45 CFR 162.408, 45 CFR 162.406
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
05/25/2007
Retrieve Notice of Action (NOA)
Date Received in OIRA:
03/21/2007
Terms of Clearance:
This collection is approved for 9 months in accordance with the following terms of clearance: CMS will provide OMB within 2 months from the date of clearance a briefing and written analysis on the feasibility of removing the request for a providers SSN on the application. OMB requests CMS provide the following information: 1. Alternative methods (other than the use of a SSN, in whole or in part) for verifying and matching the identity of individual providers requesting an NPI or updating information associated with their NPI . 2. The cost and systems redesign that would be required to remove the use of the SSN (in whole or part). Please discuss costs and system redesigns associated with implementing an alternate method(s) of verifying providers' identities. This analysis should estimate costs to the program each year over 5 years.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
02/29/2008
36 Months From Approved
02/29/2008
Responses
325,680
0
1,193,945
Time Burden (Hours)
108,560
0
448,128
Cost Burden (Dollars)
0
0
0
Abstract:
The form will be used by health care providers to apply for NPIs and to update the information collected from them whenever it changes.
Authorizing Statute(s):
None
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
71 FR 11027
12/22/2006
30-day Notice:
Federal Register Citation:
Citation Date:
72 FR 9537
03/02/2007
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
2
IC Title
Form No.
Form Name
National Provider Identifier (NPI) Application and Update Form
CMS-10114, CMS-10114, CMS-10114 (updated)
NATIONAL PROVIDER IDENTIFIER (NPI) APPLICATION/UPDATE FORM
,
National Provider Identifier (NPI) Application/Update Form
,
National Provider Identifier (NPI) Application/Update Form (updated)
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, CMS-10114 (Updated), CMS-10114
NATIONAL PROVIDER IDENTIFIER (NPI) APPLICATION/UPDATE FORM
,
National Provider Identifier (NPI) Application/Update Form
,
National Provider Identifier (NPI) Application/Update Form (updated)
ICR Summary 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
325,680
1,193,945
0
-868,265
0
0
Annual Time Burden (Hours)
108,560
448,128
0
-339,568
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
The NPI Application/Update form has been revised to further assist in uniquely identifying health care providers and provide additional guidance on how to accurately complete the form. Specifically, the form captures additional information regarding reactivations, sole proprietors, and organization subparts. Other minor changes include adding check boxes to clarify changes of information (i.e., check boxes for Add Information and Replace Information), changing the URL located under Section 5 to reflect the accurate web address, and other minor revisions. This collection also includes more detailed instructions.
Annual Cost to Federal Government:
$0
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Uncollected
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
Uncollected
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
Uncollected
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Saleda Perryman
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
03/21/2007
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