Chang Sup Lee, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

A172874 Issued in CA

Practice address

520 S Virgil Ave Ste 103
Los Angeles, CA 90020-1425

Phone

(404) 783-3508

Fax

(213) 297-7978

NPI assigned

Mar 24, 2017

Last updated

Apr 30, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Ophthalmology

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Retina Vitreous Associates Medical GroupGroup PAC ID 5799769584, 17 clinicians

Paul J Dougherty M D IncGroup PAC ID 9739171828, 16 clinicians

Pacific Eye Institute a Medical Group IncGroup PAC ID 7911966122, 43 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pih Health Good Samaritan Hospital Hospital, Los Angeles, CA, CCN 050471

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 32)

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: clee@pacificeyelaser.intellechartdirect.net
• Direct secure messaging: csuplee@rcoc.intellechartdirect.net
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Chang Sup Lee MD PC

  dba ClearVision Retina

  • Ophthalmology Physician
  • Los Angeles, CA
  • NPI 1467308866
  Medicare reassignment NPD Authorized official
• Pacific Eye Institute, a Medical Group, Inc.

  • Ophthalmology Physician
  • Upland, CA
  • NPI 1962422709
  Medicare reassignment Care Compare group NPD
• Paul J Dougherty M D Inc

  dba DLV Vision Management LLC

  • Ophthalmology Physician
  • Westlake Village, CA
  • NPI 1649203639
  Medicare reassignment Care Compare group NPD
• Retina-Vitreous Associates Medical Group PC

  • Ophthalmology Physician
  • Los Angeles, CA
  • NPI 1134164023
  Medicare reassignment Care Compare group NPD
• Efraim Duzman M.D., Inc

  • Ophthalmology Physician
  • Irvine, CA
  • NPI 1417125287
  Medicare reassignment NPD
• Retina Consultants of Orange County, a Medical Corporation

  • Retina Specialist (Ophthalmology) Physician
  • Fullerton, CA
  • NPI 1770539702
  Medicare reassignment NPD
• Usc Care Medical Group, Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1902846306

  Ophthalmology

  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment
• Pacific Eye Institute a Medical Group Inc

  • Ambulatory Surgical Clinic/Center
  • Upland, CA
  • NPI 1407932619
  NPD
• Usc Care Medical Group, Inc

  dba Fair Oaks Clinic

  • Durable Medical Equipment & Medical Supplies
  • Pasadena, CA
  • NPI 1427937390
  NPD
• Dan K Sakamoto M D Medical Corp

  • Ophthalmology Physician
  • Torrance, CA
  • NPI 1225250103
  NPD (past)
• Glen D. Jarus, M.D., Inc.

  • Retina Specialist (Ophthalmology) Physician
  • Whittier, CA
  • NPI 1124171657
  NPD (past)

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

• Pih Health Good Samaritan Hospital

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1508859323
  Care Compare affiliation

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1598296238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S VIRGIL AVE STE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201425",
            "telephone_number": "213-224-2020",
            "fax_number": "213-444-4426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S VIRGIL AVE STE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201425",
            "telephone_number": "404-783-3508",
            "fax_number": "213-297-7978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 San Pablo St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900335331",
            "country_code": "US",
            "telephone_number": "323-442-6335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 N 13th Ave",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917864904",
            "country_code": "US",
            "telephone_number": "800-345-8979",
            "fax_number": "909-949-3967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "CHANG SUP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A172874",
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CA",
            "license": "A172874",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Youngin Lee, INTERN PHARMACIST
• Cathy C Lee, M.D.
• Chan Y. Lee, D.D.S.
• Chang Roh Lee
• Chang Ryul Lee
• Changwoo Lee, DDS
• Charles Lee, M.D.
• Chelsea Lee
• Chen Yu Lee, M.D.
• Cheryl Lee, OTR/L

• Ophthalmology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.