Eduardo Antonio Michelen Gomez, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

23136 Issued in PR

Practice address

100 Grand Paseo Blvd
San Juan, PR 00926-5905

Phone

(787) 300-6074

NPI assigned

Jan 30, 2019

Sex

Male

Sole proprietor

Yes

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 PR

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

Dermatology

Education

University of Puerto Rico School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michelen Dermatology LLC

  • Dermatology Physician
  • San Juan, PR
  • NPI 1952281032
  Medicare reassignment NPD Authorized official
• Romi Dermatology LLC

  • Dermatology Physician
  • San Juan, PR
  • NPI 1023998119
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1467916726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "B6 CALLE TRAVIATA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009264256",
            "telephone_number": "787-404-3742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GRAND PASEO BLVD",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009265905",
            "telephone_number": "787-300-6074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELEN GOMEZ",
        "first_name": "EDUARDO",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-30",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PR",
            "license": "23136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MH Endocrine LLC
• MHB Ophthalmics, PSC
• Mi Farmi Farmacia LLC
• Michael Beretta
• Michelen Dermatology LLC
• Micol Hernandez Rivera LLC
• Midtown Radiology Services Inc
• Priscilla Mieses Llavat, MD
• Migdalia Espino
• Miguel a Campos Esteve PSC

• Dermatology Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• Dermatology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; 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.