REQUEST FOR NATIONAL PROVIDER IDENTIFICATION NUMBER

ICR 200712-2900-010

OMB: 2900-0702

Federal Form Document

Forms and Documents
IC Document Collections
IC ID
Document
Title
Status
179986 Modified
ICR Details
2900-0702 200712-2900-010
Historical Active 200705-2900-001
VA 2900-0702
REQUEST FOR NATIONAL PROVIDER IDENTIFICATION NUMBER
Extension without change of a currently approved collection   No
Regular
Approved without change 02/15/2008
Retrieve Notice of Action (NOA) 01/10/2008
Approved consistent with VA memo clarifying security provisions used to ensure protection of NPI data.
  Inventory as of this Action Requested Previously Approved
02/28/2011 36 Months From Approved 03/31/2008
200 0 200
10 0 10
0 0 3

Health care providers for veterans in the private sector (non-VA providers) are asking local VA medical centers for the National Provider Identifier (NPI) numbers for VA facilities and VA clinicians who have referred patients to them. The non-VA providers need these NPIs in order to receive payments from Medicare or other payers. The consequence of VA’s not providing this information is that these non-VA providers cannot get the Medicare payments and other insurance payments they deserve; some have indicated that if NPIs are not furnished, they may refuse to take care of our veterans.

PL: Pub.L. 104 - 191 1174 Name of Law: HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996
  
None

Not associated with rulemaking

  72 FR 189 10/01/2007
72 FR 238 12/12/2007
No

1
IC Title Form No. Form Name
REQUEST FOR NATIONAL PROVIDER IDENTIFICATION NUMBER 10-0449A REQUEST FOR NATIONAL PROVIDER IDENTIFICATION NUMBER

  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 200 200 0 0 0 0
Annual Time Burden (Hours) 10 10 0 0 0 0
Annual Cost Burden (Dollars) 0 3 0 0 -3 0
No
No

$424
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Denise McLamb 202-565-8374 denise.mclamb@mail.va.gov

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
01/10/2008


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