healthcare: verify CMS-10114 update path, correct NPI Enumerator address, build CMS-10114 filler
Verified firsthand against the live CMS-10114 (Rev. 02/25, OMB 0938-0931): - Section 1A confirms paper is valid for Change of Information (#2) AND Reactivation (#4), not just initial enumeration. Resolves the UNCERTAIN flag. - Current mailing address is CMS NPI Enumerator Services, Mail Stop DO-01-51, 7500 Security Blvd, Baltimore MD 21244. The old Fargo PO Box 6059 is retired; corrected in mac_routing.NPI_ENUMERATOR + all docs. - No electronic no-login equivalent exists for CMS (NPI Registry API is read-only; PECOS/NPPES-IA require login), unlike FMCSA's ask.fmcsa ticket form. So tiers stay: Standard=paper CMS-10114 (no login), Expedited=NPPES surrogate. New: cms10114_pdf_filler.py fills the flat official form via text overlay (reason checkbox + NPI + Section 2A identity + Section 4A cert name + signature anchor); wired into npi_provider._generate_10114_for_signing for nppes-update. Signed forms route to the NPI Enumerator via the existing daily batch. Tests: test_cms10114.py 27/27, test_paper_batch.py 15/15, Astro build 58 pages.
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scripts/document_gen/templates/cms10114_pdf_filler.py
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scripts/document_gen/templates/cms10114_pdf_filler.py
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"""Fill the official CMS-10114 NPI Application/Update form (flat PDF, overlay).
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The CMS-10114 is the "NPI Application/Update Form" (Rev. 02/25, OMB 0938-0931).
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Unlike the CMS-855 forms it is a **flat PDF with no AcroForm fields**, so we
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fill it by drawing a text overlay at fixed coordinates (reportlab) and merging
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that over the original page (pypdf), mirroring the stamper approach used by the
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e-sign pipeline.
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This is the Standard (no-login) path for NPPES data updates, NPI reactivation,
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and deactivation: the provider signs the certification (Section 4A individual /
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4B organization) and the signed form is mailed to:
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CMS NPI Enumerator Services
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Mail Stop DO-01-51
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7500 Security Blvd.
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Baltimore, MD 21244
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(verified against the form, page 5; the older Fargo PO Box 6059 is retired).
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Enumerator staff key the data into NPPES; no NPPES/I&A login is required.
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Section 1A "Reason for Submittal" has four mutually-exclusive checkboxes:
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1 Initial Application, 2 Change of Information, 3 Deactivation, 4 Reactivation.
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We drive the checkbox from the service slug / intake reason so the same filler
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serves nppes-update (change), npi-reactivation, and deactivation.
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Usage:
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from scripts.document_gen.templates.cms10114_pdf_filler import fill_cms10114
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pdf_bytes, anchors, missing = fill_cms10114(intake, reason="change",
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order_number="CO-1234")
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"""
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from __future__ import annotations
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import io
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import logging
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from pathlib import Path
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LOG = logging.getLogger("cms10114_pdf_filler")
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# docs/ lives two levels up from scripts/document_gen/templates/
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DOCS_DIR = Path(__file__).resolve().parents[3] / "docs"
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FORM_PATH = DOCS_DIR / "CMS-10114 Form.pdf"
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# Page index (0-based) of the actual fill-in application form pages within the
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# downloaded PDF (the first pages are instructions).
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PAGE_BASIC = 2 # Section 1 (reason + entity) and Section 2A identity
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PAGE_CERT = 4 # Section 4 certification / signature
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PAGE_W = 612.0
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PAGE_H = 792.0
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# Reason-for-submittal checkbox glyph positions (Section 1A). The checkbox sits
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# just left of each label; coordinates are the lower-left of where we draw an
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# "X". Verified from pdfplumber word boxes on the form page.
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REASON_CHECKBOX = {
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"initial": {"x": 48, "y": 610},
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"change": {"x": 48, "y": 584},
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"deactivation": {"x": 325, "y": 610},
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"reactivation": {"x": 325, "y": 508},
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}
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# Where to write the NPI for each reason (the "NPI: (Required)" line beside the
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# chosen checkbox). Change uses the left column NPI line; deactivation/
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# reactivation use the right column NPI lines.
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REASON_NPI_POS = {
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"change": {"x": 132, "y": 570},
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"deactivation": {"x": 408, "y": 599},
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"reactivation": {"x": 408, "y": 529},
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}
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# Section 2A individual identity fields (the blank row under the Prefix/First/
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# Middle/Last header at pdf_y ~320; we write on the entry row just below it).
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IDENTITY_POS = {
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"first": {"x": 168, "y": 305},
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"middle": {"x": 281, "y": 305},
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"last": {"x": 370, "y": 305},
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}
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# Section 4A (individual) printed-name fields under "First*/Middle/Last*" header.
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CERT_NAME_POS = {
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"first": {"x": 142, "y": 372},
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"middle": {"x": 280, "y": 372},
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"last": {"x": 429, "y": 372},
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}
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# Signature line for Section 4A (individual). The label "Signature (First,
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# Middle, Last...)" sits at pdf_y ~458; the blank signing line is the row above
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# it. The e-sign stamper places the provider's signature here.
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SIGNATURE_FIELDS = [
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{"field": "signer", "page": PAGE_CERT,
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"rect": [60.0, 470.0, 470.0, 490.0], "page_w": PAGE_W, "page_h": PAGE_H},
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]
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VALID_REASONS = ("initial", "change", "deactivation", "reactivation")
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# Map service slug -> default reason, so callers can pass a slug instead.
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SLUG_TO_REASON = {
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"nppes-update": "change",
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"npi-data-update": "change",
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"npi-reactivation": "reactivation",
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"npi-deactivation": "deactivation",
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"npi-enumeration": "initial",
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}
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def _split_name(full: str) -> tuple[str, str, str]:
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parts = (full or "").split()
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if not parts:
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return "", "", ""
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if len(parts) == 1:
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return parts[0], "", ""
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if len(parts) == 2:
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return parts[0], "", parts[1]
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return parts[0], parts[1][0], " ".join(parts[2:])
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def normalize_reason(reason_or_slug: str) -> str:
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r = (reason_or_slug or "").strip().lower()
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if r in VALID_REASONS:
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return r
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return SLUG_TO_REASON.get(r, "change")
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def _build_overlay(reason: str, values: dict) -> bytes:
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"""Render a multi-page overlay matching the form's page count."""
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from reportlab.lib.pagesizes import letter
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from reportlab.pdfgen import canvas
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buf = io.BytesIO()
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c = canvas.Canvas(buf, pagesize=letter)
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def draw(x, y, text, size=9):
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if not text:
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return
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c.setFont("Helvetica", size)
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c.drawString(x, y, str(text))
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# We only draw on PAGE_BASIC and PAGE_CERT; emit blank pages for the rest so
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# page indices line up when merging.
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n_pages = max(PAGE_BASIC, PAGE_CERT) + 1
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for pi in range(n_pages):
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if pi == PAGE_BASIC:
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cb = REASON_CHECKBOX.get(reason)
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if cb:
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draw(cb["x"], cb["y"], "X", size=11)
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npi_pos = REASON_NPI_POS.get(reason)
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if npi_pos and values.get("npi"):
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draw(npi_pos["x"], npi_pos["y"], values["npi"])
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draw(IDENTITY_POS["first"]["x"], IDENTITY_POS["first"]["y"], values.get("first"))
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draw(IDENTITY_POS["middle"]["x"], IDENTITY_POS["middle"]["y"], values.get("middle"))
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draw(IDENTITY_POS["last"]["x"], IDENTITY_POS["last"]["y"], values.get("last"))
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elif pi == PAGE_CERT:
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draw(CERT_NAME_POS["first"]["x"], CERT_NAME_POS["first"]["y"], values.get("first"))
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draw(CERT_NAME_POS["middle"]["x"], CERT_NAME_POS["middle"]["y"], values.get("middle"))
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draw(CERT_NAME_POS["last"]["x"], CERT_NAME_POS["last"]["y"], values.get("last"))
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c.showPage()
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c.save()
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return buf.getvalue()
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def fill_cms10114(intake: dict, reason: str = "change",
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order_number: str = "") -> tuple[bytes, list[dict], list[str]]:
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"""Fill the official CMS-10114 form via text overlay.
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Args:
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intake: dict with provider_name/first_name/last_name, npi, practice_state.
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reason: one of initial/change/deactivation/reactivation, OR a service
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slug (nppes-update, npi-reactivation, ...) which is normalized.
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order_number: for logging/traceability only.
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Returns (pdf_bytes, signature_anchors, missing_notes).
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"""
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try:
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from pypdf import PdfReader, PdfWriter
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except ImportError as exc: # pragma: no cover
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raise RuntimeError("pypdf is required to fill CMS-10114") from exc
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if not FORM_PATH.exists():
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raise FileNotFoundError(f"Official CMS-10114 not found: {FORM_PATH}")
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reason = normalize_reason(reason)
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provider = intake.get("provider_name", "")
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f, m, l = _split_name(provider)
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values = {
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"first": intake.get("first_name", f),
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"middle": intake.get("middle_initial", m),
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"last": intake.get("last_name", l),
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"npi": (intake.get("npi") or "").strip(),
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}
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overlay_bytes = _build_overlay(reason, values)
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base = PdfReader(str(FORM_PATH))
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overlay = PdfReader(io.BytesIO(overlay_bytes))
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writer = PdfWriter()
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for i, page in enumerate(base.pages):
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if i < len(overlay.pages):
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page.merge_page(overlay.pages[i])
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writer.add_page(page)
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buf = io.BytesIO()
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writer.write(buf)
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pdf_bytes = buf.getvalue()
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anchors = []
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for sig in SIGNATURE_FIELDS:
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llx, lly, urx, ury = sig["rect"]
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anchors.append({
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"field": sig["field"],
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"page": sig["page"],
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"x": float(llx) + 4,
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"y": float(lly) + 1,
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"w": float(urx - llx) - 8,
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"h": max(float(ury - lly), 18.0),
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"page_w": sig["page_w"],
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"page_h": sig["page_h"],
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})
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missing = []
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if reason in ("change", "deactivation", "reactivation") and not values["npi"]:
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missing.append(f"NPI is required for a CMS-10114 {reason} but was not provided.")
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if not (values["first"] and values["last"]):
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missing.append("Provider first/last name not collected — required on the certification.")
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if reason == "deactivation":
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missing.append("Deactivation reason (Death / Business Dissolved / Other) must be selected by reviewer.")
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if reason == "reactivation":
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missing.append("Reactivation reason free-text must be completed by reviewer.")
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if reason == "change":
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missing.append("Mark which specific fields are changing in Section 2/3 before mailing.")
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# The overlay targets the individual (Section 4A / Section 2A) path. Org
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# filings (Entity Type 2 / Section 4B) need the org variant.
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if (intake.get("enumeration_type") or "").upper() in ("NPI-2", "2", "ORGANIZATION"):
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missing.append("Organization (NPI-2) detected — complete Section 2B/4B; this overlay targets the individual path.")
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LOG.info("[cms10114] order=%s reason=%s npi=%s missing=%d",
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order_number, reason, values["npi"], len(missing))
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return pdf_bytes, anchors, missing
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if __name__ == "__main__": # quick local render for visual verification
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sample = {
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"provider_name": "Jane Q Smith",
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"npi": "1234567893",
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"practice_state": "CA",
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"enumeration_type": "NPI-1",
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}
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for r in ("change", "reactivation", "deactivation"):
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pdf, anchors, missing = fill_cms10114(sample, reason=r, order_number="CO-TEST")
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out = f"/tmp/cms10114_{r}.pdf"
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with open(out, "wb") as fh:
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fh.write(pdf)
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print(f"wrote {out} anchors={len(anchors)} missing={len(missing)}")
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