Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Shane M. Tsubaki, PA-C

Individual provider Physician Assistant · NPI 1336309384

Mr. Shane M. Tsubaki, PA-C is a Physician Assistant in Blaine, Minnesota. Qualified in 2008, 18 years ago. Practices with Minuteclinic Primary Care Minnesota PLLC, a 28-clinician group and accepts Medicare assignment.

Years since qualifying
18
In the registry since
2008
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1500 109th Ave NE
Blaine, MN 55449-4670
Phone: (866) 389-2727
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1336309384
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 12, 2008
Last updated in NPPESDecember 10, 2025
Certification dateDecember 10, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Minuteclinic Primary Care Minnesota Pllc — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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