Bounce Back Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

BOUNCE BACK PHYSICAL THERAPY

Practice address

757 E 86TH St
Indianapolis, IN 46240-1803

Phone

(317) 967-8787

NPI assigned

Jun 18, 2019

Organization subpart

No

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

Authorized official

Name

Lynn Justusson

Title

President

Phone

(800) 743-0396

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Abhishek Khosa, PT

  • Physical Therapist
  • Indianapolis, IN
  • NPI 1275767428
  Medicare reassignment NPD
• Kaushal Mahipati Patil

  • Physical Therapist
  • Kokomo, IN
  • NPI 1366096315
  Medicare reassignment NPD
• Julie Ann Pena, PT

  • Physical Therapist
  • Indianapolis, IN
  • NPI 1225826399
  Medicare reassignment

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787097600000",
    "number": "1225698541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 E 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401803",
            "telephone_number": "317-967-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 E 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401803",
            "telephone_number": "317-967-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUNCE BACK PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-18",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A",
        "authorized_official_last_name": "JUSTUSSON",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-743-0396"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Boucher, LMHCA, CSAYC
• Malik Jawuan Bouie
• Michael Boulos, M.D.
• Michael Boulous, MD
• Jennifer Bouman
• Bourke Homecare LLC
• Shawn L Bourke, NP
• Matthew Bourne, MS COUNSELING
• Vincent M Bournique, MD
• Kristen Bourque, RD, LD, CLC

• Physical Therapy Clinic/Center in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Physical Therapy Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.