Individual provider Active NPI

Shubhangi Shahaji Peche, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Glendale, AZ
National Provider Identifier
1063681336
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
57749 Issued in AZ
Practice address
5422 W Thunderbird Rd Ste 13
Glendale, AZ 85306-4717
Phone
(480) 961-2365
Fax
(480) 961-2382
NPI assigned
Feb 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 57749 AZ Primary

Addresses

Primary practice location

5422 W Thunderbird Rd Ste 13
Glendale, AZ 85306-4717

Mailing address

4505 E Chandler Blvd Ste 200
Phoenix, AZ 85048-7688
Phone (480) 961-2365

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190517002161 AZ Practitioner - NeurologyPractitioner - Pediatric Medicine 2769639756 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Neurology P C Neurology With Special Qualifications in Child Neurology CurrentSince Jan 1, 2025 Accepting new patients
Banner Physician Super Specialists Arizona LLC CurrentSince Jun 1, 2019 Accepting new patients
Banner Physician Super Specialists Arizona LLC CurrentSince Jun 1, 2019 Accepting new patients

Locations

5310 W Thunderbird Rd
Ste 308
Glendale, AZ 85306
Phone (602) 865-4442

5422 W Thunderbird Rd
Ste 13
Glendale, AZ 85306
Phone (602) 547-1024

5310 W Thunderbird Rd
Ste 301
Glendale, AZ 85306
Phone (480) 412-7474

5310 W Thunderbird Rd
Ste 110
Glendale, AZ 85306
Phone (602) 865-4065

1432 S Dobson Rd
Ste 403
Mesa, AZ 85202
Phone (480) 412-7473

1432 S Dobson Rd
Ste 509
Mesa, AZ 85202
Phone (480) 412-6970

1450 S Dobson Rd
Ste B221
Mesa, AZ 85202
Phone (480) 461-1161

1432 S Dobson Rd
Ste 301
Mesa, AZ 85202
Phone (480) 412-7120

4530 E Muirwood Dr
Ste 111
Phoenix, AZ 85048
Phone (480) 551-5469

4505 E Chandler Blvd
Ste 200
Phoenix, AZ 85048

Interoperability endpoints

  • Direct secure messaging: shubhangi.peche.1@8409.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1063681336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 E CHANDLER BLVD STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487688",
            "telephone_number": "480-961-2365",
            "fax_number": "480-961-2382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5422 W THUNDERBIRD RD STE 13",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064717",
            "telephone_number": "480-961-2365",
            "fax_number": "480-961-2382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECHE",
        "first_name": "SHUBHANGI",
        "middle_name": "SHAHAJI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-20",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "AZ",
            "license": "57749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.