National Provider Identifier (NPI) Application and Update Form

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)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0931 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-10114 National Provider Identifier (NPI) Application and Update Form Form and Instruction
CMS-10114 NPI Application and Update Form CMS-10114 - Final NPI Form - 0618.docx Form and Instruction

Information Collection (IC) Details

IC Title:	National Provider Identifier (NPI) Application and Update Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 45 CFR 162.408 45 CFR 162.406 45 CFR 142.408

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10114	NPI Application and Update Form	CMS-10114 - Final NPI Form - 0618.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,105,170	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 95 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,105,170	563,370	541,800
Annual IC Time Burden (Hours)	375,758	195,158	180,600
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.