NPIMap

Individual provider Active NPI

Peterson Fortunato Giallanza, M.D.

  • Neurology Physician
  • Huntersville, NC
National Provider Identifier
1811100142
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
200701902 Issued in NC
Practice address
10305 Hamptons Park Dr Ste 101
Huntersville, NC 28078-7221
Phone
(704) 316-5388
Fax
(704) 316-1848
NPI assigned
May 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromuscular Medicine (Psychiatry & Neurology) Physician 2084N0008X 200701902 NC
Diagnostic Neuroimaging (Psychiatry & Neurology) Physician 2084D0003X 200701902 NC
Neurology Physician 2084N0400X 2007-01902 NC
Clinical Neurophysiology Physician 2084N0600X 200701902 NC
Neurodevelopmental Disabilities Physician 2084P0005X 200701902 NC
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 200701902 NC
Vascular Neurology Physician 2084V0102X 200701902 NC
Neurology Physician 2084N0400X 200701902 NC Primary

Addresses

Primary practice location

10305 Hamptons Park Dr Ste 101
Huntersville, NC 28078-7221

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

403 Gilead Rd
Suite B
Huntersville, NC 28078-6813
Phone (704) 464-1509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080805000749 NC Practitioner - NeurologyPractitioner - Sleep Medicine 8527132752 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Sleep Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

190 Kimel Park Dr
Suite 120
Winston Salem, NC 27103-6946
Phone (336) 718-7300

Hospital & facility affiliations

  • Adoration Home Health Home health agency, Concord, NC, CCN 347126
  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
  • Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183
  • Novant Health Mint Hill Medical Center Hospital, Charlotte, NC, CCN 340190
  • Novant Health Rowan Medical Center Hospital, Salisbury, NC, CCN 340015
  • Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200701902NCMDNeuromuscular Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina Neurology and Sleep PLLC CurrentSince Jul 9, 2012 Accepting new patients
Novant Health Medical Group, LLC Clinical Neurophysiology Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Feb 15, 2025 Accepting new patients
Novant Health Medical Group, LLC Neurology CurrentSince Feb 15, 2025 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

10305 Hamptons Park Dr
Ste 101
Huntersville, NC 28078
Phone (704) 316-5388

403 Gilead Rd
Ste B
Huntersville, NC 28078
Phone (704) 464-1509

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

190 Kimel Park Dr
Ste 120
Winston Salem, NC 27103
Phone (336) 277-2200

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9866d918-4ba0-4040-b294-ab19b8bedf0b/

Organizations & group practices 18

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 18

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1811100142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10305 HAMPTONS PARK DR STE 101",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787221",
            "telephone_number": "704-316-5388",
            "fax_number": "704-316-1848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "403 Gilead Rd",
            "address_2": "SUITE B",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280786813",
            "country_code": "US",
            "telephone_number": "704-464-1509",
            "fax_number": "704-464-1393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIALLANZA",
        "first_name": "PETERSON",
        "middle_name": "FORTUNATO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "NC",
            "license": "200701902",
            "primary": false
        },
        {
            "code": "2084D0003X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Diagnostic Neuroimaging",
            "state": "NC",
            "license": "200701902",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2007-01902",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NC",
            "license": "200701902",
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "NC",
            "license": "200701902",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "NC",
            "license": "200701902",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "NC",
            "license": "200701902",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "200701902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

Verify at the official NPI Registry.