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Active NPI 1336309384 Individual Practitioner Male Practitioner

Shane M. Tsubaki , PA-C

Physician Assistant • Blaine, MN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Shane Tsubaki, PA-C is a certified Physician Assistant practicing in Blaine, MN. With approximately 18 years of clinical experience since completing medical education in 2008, Shane Tsubaki delivers high-quality medical care to the local community at 1500 109TH AVE NE.

Shane Tsubaki maintains professional affiliations with Minuteclinic Primary Care Minnesota Pllc, Minuteclinic Diagnostic Of Minnesota Pa and accepts Medicare assignment.

Frequently performed procedures and clinical services include new patient outpatient office visit, established patient outpatient office visit, detection test by immunoassay technique for severe acute respiratory syndrome coronavirus. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1500 109th Ave Ne

Blaine, MN 554494670

Telephone 8663892727
Associated Practice Facility / Clinic
🏢 Grand St Paul Cvs Llc Facility NPI 1215959903

Medicare Profile & Education

Medical School

Other

Graduation Year

2008

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Blaine, MN

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
18 Yrs +8.2 yrs vs City Avg
City Avg: 9.8 Yrs
State Avg: 10.9 Yrs
Regional Practice Density
26 Specialists

Practicing in Blaine, MN (4026 Statewide)

Telehealth Adoption Rate
7.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
47.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Tsubaki (18 Years) 18 Yrs
Blaine Specialty Average (9.8 Years) 9.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
23 23 $175.84 $93.28

Medical Specialties & State Licenses

CMS Verified: 2025-12-10
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Hospital & Practice Group Affiliations

Minuteclinic Diagnostic Of Minnesota Pa

15800 87th St Ne, Otsego, MN 553306546

Phone: 8663892727

Minuteclinic Diagnostic Of Minnesota Pa

6300 Wedgwood Rd N, Maple Grove, MN 553113647

Phone: 8663892727

Minuteclinic Primary Care Minnesota Pllc

1500 109th Ave Ne, Blaine, MN 554494670

Phone: 8663892727

Minuteclinic Diagnostic Of Minnesota Pa

3633 Bunker Lake Blvd Nw, Andover, MN 553047402

Phone: 8663892727

Minuteclinic Diagnostic Of Minnesota Pa

1500 109th Ave Ne, Blaine, MN 554494670

Phone: 8663892727

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Nicole Wagschal , MSN APRN

Nurse Practitioner - Family

NPI 1003013525

MSNAPRN

Shelly Gallini , PA-C

Physician Assistant

NPI 1003089210

Physician Assistant (Certified)

Dr. Lilia Pino , PhD, ARNP

Nurse Practitioner - Family

NPI 1003094855

Doctor of Philosophy (Ph.D.), Advanced Registered Nurse Practitioner

Maria Gagliano , FNP

Nurse Practitioner - Family

NPI 1003160532

Family Nurse Practitioner

Jennifer Price , APRN

Nurse Practitioner - Family

NPI 1003185570

Advanced Practice Registered Nurse

Megan Lottes , NP-C

Nurse Practitioner - Family

NPI 1003196965

Nurse Practitioner (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Practice Location December 10, 2025

Registered at 1500 109TH AVE NE, BLAINE, MN 554494670 (Tel: 8663892727)

NPI Profile Active August 04, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location August 04, 2016

Registered at 11990 BUSINESS PARK BLVD N, CHAMPLIN, MN 55316 (Tel: 8663892727)

📍
Updated Business Mailing Address August 04, 2016

Registered at 15744 FAIROAKS AVE N, HUGO, MN 550388552 (Tel: 5412129382)

👤
Provider Name / Credentials Updated August 04, 2016

Recorded as SHANE TSUBAKI, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 04, 2016

Physician Assistant

🟢
Initial NPI Registration & Enumeration June 12, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1336309384
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 12, 2008
Last Update: December 10, 2025
Sole Proprietor: No

Mailing Address

15744 Fairoaks Ave N

Hugo, MN 550388552

Phone: 5412129382

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.