Individual provider Active NPI

Sarah Calumbine Pegouskie, APRN, FNP

  • Nurse Practitioner
  • Fairbanks, AK
National Provider Identifier
1558091587
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
196730 Issued in AK
Practice address
1717 W Cowles St
Fairbanks, AK 99701-5926
Phone
(907) 451-6682
NPI assigned
Jun 13, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Paramedic 146L00000X P095433 NC
Critical Care Medicine Registered Nurse 163WC0200X 163754 AK
Registered Nurse 163W00000X 163754 AK
Registered Nurse 163W00000X 296823 NC
Nurse Practitioner 363L00000X 196730 AK Primary

Addresses

Primary practice location

1717 W Cowles St
Fairbanks, AK 99701-5926

Mailing address

1099 Tena Ave
Fairbanks, AK 99701-1422
Phone (989) 390-2962

Other names 1

  • Mrs. Sarah Calumbine Pegouskie Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221121001943 TX Practitioner - Nurse Practitioner 1658749726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanana Chiefs ConferenceGroup PAC ID 9537050109, 148 clinicians
Bristol Bay Area Health CorporationGroup PAC ID 5890699920, shared by 4 NPIs, 114 clinicians

Practice addresses (Care Compare)

1717 W Cowles St
Fairbanks, AK 99701-5926
Phone (907) 451-6682

6000 Kanakanak Rd
Dillingham, AK 99576-0130
Phone (907) 842-5201

P O Box
Dillingham, AK 99576-0130

PO Box
Suite 130
Dillingham, AK 99576-0130
Phone (907) 842-5201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
P095433NCMDParamedic
163754AKMDRegistered Nurse
296823NCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Tanana Chiefs Conference CurrentSince Oct 24, 2022 Accepting new patients
Tanana Chiefs Conference CurrentSince Oct 24, 2022 Accepting new patients

Locations

1717 W Cowles St
Fairbanks, AK 99701
Phone (907) 452-6682

Interoperability endpoints

  • Direct secure messaging: sarah.hamilton.1@15989.direct.athenahealth.com

Organizations & group practices 2

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": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1558091587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 TENA AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997011422",
            "telephone_number": "989-390-2962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015926",
            "telephone_number": "907-451-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEGOUSKIE",
        "first_name": "SARAH",
        "middle_name": "CALUMBINE",
        "credential": "APRN, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "NC",
            "license": "P095433",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "AK",
            "license": "163754",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AK",
            "license": "163754",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "296823",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AK",
            "license": "196730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "PEGOUSKIE",
            "middle_name": "CALUMBINE",
            "prefix": "MRS.",
            "credential": "APRN, FNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.