We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • Executive Forms
  • Executive Department HHS Forms
  • Cms-10114 2018

Get Cms-10114 2018-2025

S FOR COMPLETING THE NATIONAL PROVIDER IDENTIFIER (NPI) APPLICATION/UPDATE FORM Please PRINT or TYPE all information so it is legible. Use only blue or black ink. Do not use pencil. Failure to provide pages 3, 4, and 5 with complete and accurate information may cause your application to be returned and delay processing of your application. In addition, you may experience problems being recognized by insurers if the records in their systems do not match the information you have furnished on this .

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the CMS-10114 online

The CMS-10114 form is essential for health care providers seeking to obtain or update their National Provider Identifier (NPI). This guide offers clear, step-by-step instructions on how to complete this form online, ensuring accurate and efficient processing.

Follow the steps to complete the CMS-10114 online effectively.

  1. Click the ‘Get Form’ button to access the CMS-10114 online, where you can begin filling it out.
  2. In Section 1, select the reason for submitting the form: Initial Application, Change of Information, Deactivation, or Reactivation. Ensure you check the appropriate box and provide any required details.
  3. In Section 1B, choose the entity type by checking either 'Entity Type 1' for individuals or 'Entity Type 2' for organizations. Only select one option.
  4. Proceed to Section 2, where you will provide identifying information. For individuals, fill out your full legal name, date of birth, gender, and if applicable, additional names. For organizations, provide the legal business name and Employer Identification Number (EIN).
  5. In Section 3, input your correspondence mailing address and business practice location. This information must be complete to facilitate contact regarding your application.
  6. Fill out any additional provider identification numbers and taxonomy codes in Section 3C and 3D if applicable, ensuring the details are accurate.
  7. In Section 4, sign the certification statement. This requires the signature of the individual for Type 1 or the authorized official for Type 2 organizations. Be sure to include the date.
  8. Finally, provide contact information in Section 5 for a person who can answer questions related to your application. This ensures that any inquiries can be directed to the appropriate individual.
  9. Once the form is completed, review all entries for accuracy before submitting. You can save changes, download a copy, print, or share the form as needed.

Follow these instructions to complete your CMS-10114 online and ensure efficient processing of your application.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

CMS 10114
CMS 10114 Form Title: NATIONAL PROVIDER IDENTIFIER (NPI) APPLICATION/UPDATE FORM Revision...
Learn more
NPI: What You Need to Know
NPI Application/Update Form (CMS-10114). Make sure they read the Penalties for Falsifying...
Learn more
FORM 10-K NVIDIA CORPORATION - Cloudfront.net
Feb 26, 2021 — Generally, these manufacturers assemble and test the boards based on our...
Learn more

Related links form

Sample Special Power Of Attorney For Bank Transactions Philippines 2020 Ddr Savings Account Form Criminal Record Template 2020 Kashmir University B Ed Degree Certificate

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

To update your NPI information online, visit the NPPES website and log into your account. It is essential to provide accurate and complete details to ensure compliance with CMS-10114 standards. If you need assistance with the process, USLegalForms offers solutions to simplify and streamline your updates.

Entities that must provide creditable coverage disclosures to CMS include employers offering health insurance, Medicare Part D sponsors, and any plan sponsor that provides prescription drug coverage. This ensures that all stakeholders are aware of coverage statuses, aligning with the CMS-10114 requirements for clear communication.

Yes, failing to file a CMS disclosure can result in significant penalties for your organization. These penalties may include fines or sanctions, affecting your ability to operate within the healthcare system. By adhering to the CMS-10114 requirements, you can avoid these complications and keep your organization compliant.

Reactivating a National Provider Identifier (NPI) number typically takes around 20 business days. However, the timeframe may vary based on the complexity of your application and existing data with CMS. To expedite this process, ensure you have accurate information submitted through the CMS-10114 guidelines.

CMS reporting is required for organizations that provide health coverage, often including insurers, group health plans, and Medicare Advantage plans. If your organization falls within these categories, you must file reports to comply with CMS-10114. This helps keep the federal health system informed and functioning correctly.

Creating a CMS file involves gathering relevant data about your health plans and formatting it as per CMS requirements. It's essential to use the guidelines provided on the CMS-10114 documentation to ensure all necessary information is included. USLegalForms can assist you in creating a CMS file that meets all regulatory standards, making the process easier.

Any organization that offers health plans or coverage under Medicare must file a CMS disclosure. This includes employers, insurers, and any entity that administers Medicare benefits. By complying with the CMS-10114 requirements, these organizations ensure that they meet federal regulations and provide necessary information regarding their health plans.

A CMS number refers to the unique identifier assigned by the Centers for Medicare & Medicaid Services for providers and healthcare facilities. This number is critical for billing and reporting purposes within the Medicare and Medicaid systems. Understanding your CMS number can help you navigate the healthcare landscape more effectively. For detailed information on its significance, you can browse the resources available on uslegalforms.

To access CMS, you will need to create a user account on the CMS website. This process includes providing valid identification and credentials that verify your professional status. Once registered, you can access various tools and resources to assist you in your healthcare practices. If you need further help with registration, uslegalforms offers resources to streamline the process.

Obtaining a CMS certification number requires you to fill out an application and provide details about your healthcare services. After submitting your application, CMS will review it and confirm your eligibility. Successful applicants will receive a certification number that can be used for various Medicare and Medicaid services. For assistance with this, you can rely on the user-friendly resources at uslegalforms.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get CMS-10114
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232