Individual provider Active NPI

Carensa Cezar

  • Gastroenterology Physician
  • Douglasville, GA
National Provider Identifier
1124587001
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
104392 Issued in GA
Practice address
8901 Stonebridge Blvd Ste 200
Douglasville, GA 30134-2254
Phone
(470) 610-0145
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X FL
Gastroenterology Physician 207RG0100X 104392 GA Primary

Addresses

Primary practice location

8901 Stonebridge Blvd Ste 200
Douglasville, GA 30134-2254

Mailing address

8901 Stonebridge Blvd Ste 200
Douglasville, GA 30134-2254
Phone (470) 610-0145

Other practice location 1

1611 NW 12th Ave
Miami, FL 33136-1005
Phone (601) 826-3588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20250829003085 GA Practitioner - Gastroenterology 8921488305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Howard University College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

8901 Stonebridge Blvd
Suite 200
Douglasville, GA 30134-2254
Phone (943) 202-7120

8954 Hospital Dr
Douglasville, GA 30134-2272
Phone (678) 838-2585

Hospital & facility affiliations

  • Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Aug 1, 2025 Accepting new patients
Wellstar Cardiovascular Medicine, LLC PastSince Sep 14, 2025 Accepting new patients

Locations

8901 Stonebridge Blvd
Ste 200
Douglasville, GA 30134
Phone (943) 202-7030

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1124587001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 STONEBRIDGE BLVD STE 200",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342254",
            "telephone_number": "470-610-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 STONEBRIDGE BLVD STE 200",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342254",
            "telephone_number": "470-610-0145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 NW 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361005",
            "country_code": "US",
            "telephone_number": "601-826-3588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEZAR",
        "first_name": "CARENSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "104392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.