Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jonah Bourassa

Individual provider Physical Therapist · NPI 1558193300

Jonah Bourassa is a Physical Therapist in Private Practice in Terre Haute, Indiana. Qualified in 2024, 2 years ago. Practices with Protailored Physical Therapy LLC, a 23-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
2
Licensed in
IN
In the registry since
2024
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Practice location Address checks out

3177 S 3rd Pl
Terre Haute, IN 47802-3785
Phone: (812) 514-3096
Fax: (812) 301-6667
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X (IN)

Record details

NPI number1558193300
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 19, 2024
Last updated in NPPESJune 30, 2026
Certification dateJune 30, 2026
Mailing address790 Remington Blvd, Bolingbrook, IL 60440-4909

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Protailored Physical Therapy Llc — 23 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Terre Haute