From: PDMCOGZ@cigna.com     Hi,     Thank you for your submission.     The attached request has been reviewed.     See below the current status of the requested provider with Name, PID #, TIN # and Eff. Date.     HCP NAME  PID  TIN  STATUS  GLORY ABRAHAM  4048834  270796429  NON-CONTRACTED     Cigna Internal Ref. ID : W202007151135367         Note : TIN’s was not contracted for the providers “GLORY ABRAHAM” If we need to have your provider loaded under your group TIN, kindly submit the below requested information to Intake_PDM@Cigna.com.        New Add Request  1. Provider ID or Provider Name  2. Effective Date  3. Office and Billing address and phone numbers  4. Group Name  5. Payee Name  6. Hospital ( IL see GMI. No hospital loaded  in provider's record, LA & TX for HBP providers)  7. Network IDs  8. Fee Schedule (if no GSI attached)  9. TIN  10. Degree  11. Specialty  12. Role  13. Place of Service (Hospital Based or not)  14. License #  15. A W-9 is required for TIN owner name and address for non-delegated TINS that do not exist in CPF.  16. Market Suppression  17. On Call required for PCP  18. NPI (National Provider Identifier) Individual HCP's  Note:  This is required for all new Adds for non-atypical HCPs  19. Internet Information - If given in source document and California HCP.        Please do not reply to this email message. The return address is not monitored. All future request should be sent to Intake_PDM@cigna.com        Sincerely,  Cigna PDM