Individual provider Active NPI

Kaitlyn Dubay

  • Physical Therapist
  • Fargo, ND
National Provider Identifier
1831021807
Registry record updated Oct 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2867 Issued in ND
Practice address
1461 Broadway N
Fargo, ND 58102-2622
Phone
(701) 293-6037
NPI assigned
Jun 2, 2026
Last updated
Oct 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 2867 ND
Physical Therapist 225100000X 2867 ND Primary

Addresses

Primary practice location

1461 Broadway N
Fargo, ND 58102-2622

Mailing address

1461 Broadway N
Fargo, ND 58102-2622
Phone (701) 290-8459

Other names 1

  • Kaitlyn Berreau Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2026
Medicare assignment
May accept Medicare assignment
Group practices
Myna Therapy Services PLLCGroup PAC ID 8022499888, 10 clinicians

Practice addresses (Care Compare)

4575 23Rd Ave S
Suite 400
Fargo, ND 58104-8783
Phone (701) 347-1782

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2867NDMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Myna Therapy Services PLLC Physical Therapist CurrentSince Jun 15, 2026 Accepting new patients
Myna Early Intervention LLC CurrentSince Jun 15, 2026 Accepting new patients
Total Balance Dietitian, LLC PastSince Mar 24, 2024 Accepting new patients
Total Balance Physical Therapy and Fitness, LLC Physical Therapist PastSince May 20, 2024 Accepting new patients

Locations

4575 23rd Ave S
Ste 400
Fargo, ND 58104
Phone (701) 347-1782

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1780358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793232000000",
    "number": "1831021807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1461 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581022622",
            "telephone_number": "701-290-8459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581022622",
            "telephone_number": "701-293-6037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBAY",
        "first_name": "KAITLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-02",
        "last_updated": "2026-10-29",
        "certification_date": "2026-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "ND",
            "license": "2867",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "2867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "BERREAU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.