Siraj Issak

Key facts

NPI

1003767559

Entity type

Individual (NPI type 1)

Primary specialty

Private Vehicle 347C00000X

License

Z000-034-100 (MN)

Practice address

1323 23Rd St S Ste D
Fargo, ND 58103-3759

Phone

(701) 781-0208

NPI assigned

Feb 9, 2026

Sex

Male

Sole proprietor

No

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.

• Mobility Bridge LLC Peer Specialist · Fargo, ND · NPI 1932069945
  NPD Authorized official PEER SPECIALIST
• S&J Medical Transportation LLC Non-emergency Medical Transport (VAN) · Fargo, ND · NPI 1659107142
  NPD Authorized official

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 9, 2026.

{
    "created_epoch": "1770595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1003767559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 23RD ST S STE D",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033759",
            "telephone_number": "701-781-0208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1323 23RD ST S STE D",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033759",
            "telephone_number": "701-781-0208"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1323 23rd St S Ste H",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581033759",
            "country_code": "US",
            "telephone_number": "218-331-5544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISSAK",
        "first_name": "SIRAJ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-02-09",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "MN",
            "license": "Z000-034-100",
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "ND",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Fargo, ND · Private Vehicle in North Dakota