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OMB Control No:	ICR Reference No: 202610-0906-002
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: Applicant Organizational National Provider Identifiers and Centers for Medicare & Medicaid Services Certification Numbers Form
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 10/13/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	6,375	0
Time Burden (Hours)	281	0
Cost Burden (Dollars)	0	0

Abstract: HRSA is proposing a new form to collect organizational National Provider Identifiers (Type 2 NPIs) and CMS Certification Numbers (CCNs) from organizations that apply for HRSA award funding through Grants.gov. This collection is authorized under section 301 of the Public Health Service Act (42 U.S.C. 241), which authorizes the Secretary of Health and Human Services to conduct and support research, investigations, experiments, demonstrations, and studies relating to the causes, diagnosis, treatment, control, and prevention of disease, and to collect and make available information on those activities, including the provision of technical assistance on statistical methods. The authority for this collection is 42 U.S.C. 241. The form will be completed as part of the Grants.gov funding application. This collection is limited to organizational identifiers and will only collect an NPI and/or CCN only from organizations that already have one. An organization is not required to have, or to obtain, an NPI or CCN in order to apply for or receive HRSA funding, and individual applicants (persons) are not asked to provide an individual (Type 1) NPI. The purpose of this proposed collection is to strengthen the evidence HRSA uses to understand how it meets its mission of improving health outcomes through access to quality services, a skilled health workforce, and innovative, high-value programs. The circumstance making this collection necessary is that HRSA currently lacks an identifier that reliably and consistently identifies funded organizations across its many programs and across externally available healthcare delivery system data. All applicants for HRSA funding through Grants.gov must obtain a Unique Entity Identifier (UEI) from SAM.gov before beginning a funding application. The UEI identifies the legal entity that receives an award, but it is not used in healthcare transactions and does not appear in CMS claims, encounter, certification, or quality datasets. As a result, HRSA cannot use the UEI to connect its award and program data to the external healthcare delivery system. Organizational NPIs and CCNs address this gap because they are already embedded as standard provider-identity keys in widely used, publicly available CMS datasets.

Authorizing Statute(s): PL: Pub.L. 42 - 241 301 Name of Law: Public Health Service Act

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:
	91 FR 47253	07/28/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 64663	10/09/2026
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Applicant Organization NPI and CMS CCN Form	1

ICR Summary of Burden

	Total Request	Change Due to Agency Discretion
Annual Number of Responses	6,375	6,375
Annual Time Burden (Hours)	281	281
Annual Cost Burden (Dollars)	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: No

Burden Reduction Due to:

Short Statement: This is a new collection.

Annual Cost to Federal Government: $133,354

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Catherine Bourassa 301 443-5039 cbourassa@hrsa.gov

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