Shane M. Tsubaki, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1500 109TH Ave NE
Blaine, MN 55449-4670

Phone

(866) 389-2727

NPI assigned

Jun 12, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Shane M. Yoshimoto Former name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minuteclinic Primary Care Minnesota PLLCGroup PAC ID 2163945460, 30 clinicians

Minuteclinic Diagnostic of Minnesota PAGroup PAC ID 7810289949, 83 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

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.

• Minuteclinic Primary Care Minnesota PLLC

  • Family Nurse Practitioner
  • Eagan, MN
  • NPI 1104632801

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Minuteclinic Diagnostic of Minnesota, P.a.

  • Family Nurse Practitioner
  • Eagan, MN
  • NPI 1407227945
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1336309384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15744 FAIROAKS AVE N",
            "city": "HUGO",
            "state": "MN",
            "postal_code": "550388552",
            "telephone_number": "541-212-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 109TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494670",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSUBAKI",
        "first_name": "SHANE",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANE",
            "last_name": "YOSHIMOTO",
            "middle_name": "M.",
            "prefix": "MR.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lori Jean Treb
• Nhan Trinh
• John Harold Troselius, D.D.S.
• Amanda L Tschida-Schirmers, OTR/L, CHT
• Nicholas Robert Tschida, PT
• Visweswari Tupakula
• Twin Anesthesia LLC
• Twin Anesthesia LLC
• Twin Cities Hope and Healing Center
• Twin Cities Occupational Health & Rehab

• Physician Assistant in Blaine, MN
• Providers in Blaine, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.