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Announcing the Revised CMS-10114 National Provider Identifier (NPI) Application/Update Form

The National Provider Identifier (NPI) Application/Update Form (CMS-10114) has been revised to provide additional guidance on how to accurately complete the form. The revised form was recently approved by the Office of Management and Budget (OMB). The revised version of the form is currently available to view and download from the CMS Forms website at http://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads/CMS10114.pdf.  A link to the downloadable form can also be found below under ‘Downloads’.  In addition, the form can be obtained by contacting the NPI Enumerator at 1-800-465-3203.

Providers should begin sending the revised form to the NPI Enumerator, effective immediately. The old version of the CMS-10114 may continue to be sent to the NPI Enumerator as long as they are postmarked by December 31, 2012 or earlier.

Health care providers can apply for NPIs in one of three ways:

  • For the most efficient application processing and the fastest receipt of NPIs, use the web-based application process.  Simply log onto the National Plan and Provider Enumeration System (NPPES) and apply on line (see ‘Apply Now’ link under the Related Links section below).
  • Health care providers can agree to have an Electronic File Interchange (EFI) organization (EFIO) submit application data on their behalf (i.e., through a bulk enumeration process) if an EFIO requests their permission to do so (See ‘EFI’ link on left hand column for more information regarding this process).
  • Health care providers may wish to obtain a copy of the paper NPI Application/Update Form (CMS-10114) and mail the completed, signed application to the NPI Enumerator located in Fargo, ND, whereby staff at the NPI Enumerator will enter the application data into NPPES.  This form is now available for download from the CMS website (see link to the form under Downloads below) or by request from the NPI Enumerator.  Health care providers who wish to obtain a copy of this form from the NPI Enumerator may do so in any of these ways:
    • Phone:  1-800-465-3203 or TTY 1-800-692-2326
    • E-mail:  customerservice@npienumerator.com
    • Mail:
      NPI Enumerator
      P.O. Box 6059  
      Fargo, ND  58108-6059