Individual Healthcare Provider
Mary Iaculli, D.O.
Provider's NPPES record last updated: October 2, 2020
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1407266778
- Primary Specialty
- Family Medicine — Sports Medicine
- Practice Location
- Portland, Maine
- Sole Proprietor
- Yes
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 6:48 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Family Medicine
Sports Medicine
Allopathic & Osteopathic Physicians
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Taxonomy code 207QS0010X
Provider-Reported License Information
- Family Medicine (Maine)
- DO2695
Practice Locations
Practice Location
331 Veranda St
Portland, Maine 04103-5545
Phone: (207) 828-2402
Additional Practice Location
1 Boston Medical Ctr Pl
Boston Medical Center
Boston, Massachusetts 02118-2908
Phone: (585) 738-4986
Additional Practice Location
15 E Chestnut St
Augusta, Maine 04330-5736
Phone: (207) 623-6663
Additional Practice Location
77 Bates St Ste 201
Lewiston, Maine 04240-7637
Phone: (207) 795-8465
Record Information
- Enumeration Date
- May 7, 2014
- Provider's NPPES Record Last Updated
- October 2, 2020
- Certification Date
- September 17, 2020
- NPISignal NPPES Dataset
- August 2026
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