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STONY CREEK INTERNAL MEDICINE PLC
NPI 1093835647
Internal Medicine in Shelby Township, MI

Active since March 29, 2007CLIA 23D1017868 · Waiver
52915 MOUND ROAD, SHELBY TOWNSHIP, MI 48316(586) 992-2400 Get Directions Write a Review

NPPES record last updated: December 19, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Stony Creek Internal Medicine Plc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STONY CREEK INTERNAL MEDICINE PLC (NPI 1093835647) is a healthcare organization registered as an internal medicine in Shelby Township, Michigan and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through October 6, 2027 and lists Lisa Hall, Owner, as its authorized official.

NPPES Registry Identity

NPI1093835647
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameSTONY CREEK INTERNAL MEDICINE PLC
Location Address52915 MOUND ROADShelby Township, MI 48316-3266
Mailing Address52915 Mound RoadShelby Township, MI 48316-3266 · (586) 992-2400 · Fax (586) 992-8206
Phone(586) 992-2400
Organization SubpartNo
Authorized OfficialLisa HallOwner · (586) 992-2400
Enumeration DateMarch 29, 2007
Last NPPES UpdateDecember 19, 2012
✔ NPI 1093835647 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedFamily MedicineTaxonomy 207Q00000X
52915 MOUND ROAD, Shelby Township, MI 48316
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stony Creek Internal Medicine Plc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by October 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateMichiganEnrollment IDO20040421001117Non-DME Part B · Clinic/Group PracticeDue dateOctober 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Stony Creek Internal Medicine Plc, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Lisa Hall, M.D.
Internal Medicine
NPI 1992864417
52915 MOUND ROAD
Shelby Township, MI 48316
(586) 992-2400
✔ PECOS✔ Accepts MedicareSame address
Alicia Gaspar, FNP-C
Nurse Practitioner
NPI 1740729961
52930 MOUND RD
Shelby Twp, MI 48316
(586) 992-2400
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D1017868

Stony Creek Internal Medicine · Shelby Township, MI
Active · expires Oct 6, 2027
CLIA Number23D1017868
Laboratory TypePhysician Office
Certificate Effective DateOctober 7, 2025
Certificate Expiration DateOctober 6, 2027
Laboratory DirectorLisa M. Hall
Laboratory Phone(586) 992-2400
Laboratory LocationStony Creek Internal Medicine52930 Mound Road, Shelby Township, MI 48316
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stony Creek Internal Medicine Plc's NPI number?

The NPI number for Stony Creek Internal Medicine Plc is 1093835647. It was assigned to this organization in the NPPES registry on March 29, 2007.

Where is Stony Creek Internal Medicine Plc located?

Stony Creek Internal Medicine Plc is located at 52915 Mound Road, Shelby Township, MI 48316. The listed phone number is (586) 992-2400.

What is Stony Creek Internal Medicine Plc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Stony Creek Internal Medicine Plc enrolled in Medicare?

Yes. Stony Creek Internal Medicine Plc is registered in the Medicare PECOS enrollment system.

When is Stony Creek Internal Medicine Plc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Stony Creek Internal Medicine Plc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Stony Creek Internal Medicine Plc, in Internal Medicine and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Stony Creek Internal Medicine Plc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D1017868) is associated with this NPI, valid through October 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Stony Creek Internal Medicine Plc accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company list Stony Creek Internal Medicine Plc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Stony Creek Internal Medicine Plc was last updated on December 19, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.