	 Reference #: 3212920884  Dear NUBIA BENAVIDES:  Novitas Solutions, Inc. has approved your Change of Information (COI) application.  Medicare Enrollment Information Individual Name: NUBIA BENAVIDES Individual Specialty: NURSE PRACTITIONER Individual National Provider Identifier (NPI): 1801371935 Individual Provider Transaction Access Number (PTAN): 1V8347 Group Legal Business Name (LBN): VALLEY MED URGENT CARE PLLC Group NPI: 1518404631 Group PTAN: 578343 Reassignment Effective Date: SEPTEMBER 1, 2021 Changed Information: N/A  Please find attachments: