Individual provider Active NPI

Kian Ali Modanlou, M.D.

  • Surgery Physician
  • Englewood, CO
National Provider Identifier
1790858520
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
DR.0041865 Issued in CO
Practice address
701 E Hampden Ave Ste 420
Englewood, CO 80113-2760
Phone
(303) 789-1877
Fax
(303) 789-2628
NPI assigned
Nov 17, 2006
Last updated
May 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician 204F00000X 2006020979 MO
Surgery Physician 208600000X 2006020979 MO
Surgery Physician 208600000X DR.0041865 CO Primary

Addresses

Primary practice location

701 E Hampden Ave Ste 420
Englewood, CO 80113-2760

Mailing address

8490 E Crescent Pkwy Ste 380
Greenwood Village, CO 80111-2815
Phone (303) 957-1310

Other practice location 1

1000 Lincoln St Ste 207
Fort Morgan, CO 80701-3290
Phone (970) 542-4371

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kian.modanlou@surgone.directbygreenway.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150828001871 CO Practitioner - General Surgery 5890796635 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of California, Davis School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians
Surgone PCGroup PAC ID 9032002985, 39 clinicians

Practice addresses (Care Compare)

1000 Lincoln St
Fort Morgan, CO 80701-3290
Phone (970) 542-4371

1601 E 19TH Ave
Suite 6300
Denver, CO 80218-1255
Phone (303) 839-5669

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)16
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2006020979MOMDTransplant Surgery Physician
DR.0041865COMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgone, PC Surgery CurrentSince Feb 1, 2018 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Portercare Adventist Health System CurrentSince Aug 1, 2015 Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Traumaone, PLLC CurrentSince Jan 1, 2018 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Mar 1, 2025 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Mar 1, 2025 Accepting new patients
Surgone, PC Transplant Surgery CurrentSince Feb 1, 2018 Accepting new patients

Locations

2350 Meadows Blvd
Castle Rock, CO 80109
Phone (720) 248-3413

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

2535 S Downing St
Ste 380
Denver, CO 80210
Phone (303) 260-2740

2525 S Downing St
Denver, CO 80210
Phone (303) 744-2706

1601 E 19th Ave
Ste 6300
Denver, CO 80218
Phone (303) 839-5669

3333 S Bannock St
Ste 350
Englewood, CO 80110
Phone (303) 957-1310

701 E Hampden Ave
Ste 420
Englewood, CO 80113
Phone (303) 789-1877

1000 Lincoln St
Ste 207
Fort Morgan, CO 80701
Phone (970) 542-4371

1000 Lincoln St
Ste 208
Fort Morgan, CO 80701
Phone (970) 542-4371

8490 E Crescent Pkwy
Ste 380
Greenwood Village, CO 80111
Phone (303) 957-1310

10103 Ridgegate Pkwy
Ste 217
Lone Tree, CO 80124
Phone (303) 789-1877

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Interoperability endpoints

  • Direct secure messaging: kian.modanlou@surgone.directbygreenway.com

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1790858520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8490 E CRESCENT PKWY STE 380",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112815",
            "telephone_number": "303-957-1310",
            "fax_number": "303-761-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E HAMPDEN AVE STE 420",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132760",
            "telephone_number": "303-789-1877",
            "fax_number": "303-789-2628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Lincoln St Ste 207",
            "address_purpose": "LOCATION",
            "city": "Fort Morgan",
            "state": "CO",
            "postal_code": "807013290",
            "country_code": "US",
            "telephone_number": "970-542-4371",
            "fax_number": "970-542-4373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MODANLOU",
        "first_name": "KIAN",
        "middle_name": "ALI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "MO",
            "license": "2006020979",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2006020979",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "DR.0041865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kian.modanlou@surgone.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "701 E Hampden Ave Ste 420",
            "city": "Englewood",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801132760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.