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Log In to Your Re-Enrollment Application
Please enter your Application Tracking Number (ATN) found on your re-enrollment notification letter or contact the Provider Assistance Center at 1-800-842-8440 for assistance in obtaining your ATN.
Required fields are indicated with an asterisk (*)
ATN*
ATN*
ATN: Required input must be between 1 And 9.
ATN: Only numeric Values are allowed.
NPI/Non medical provider identifier (AVRS ID)*
NPI/Non medical provider identifier (AVRS ID)*
NPI/Non medical provider identifier (AVRS ID): Required input must be between 9 And 10.
NPI/Non medical provider identifier (AVRS ID): Only numeric Values are allowed.
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