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

Ainie Soetanto, MD

Individual provider Vascular Neurology Physician · NPI 1942640644

Ainie Soetanto, MD is a Neurology in Bronx, New York. Graduated from Albert Einstein College of Medicine of Yeshiva University in 2013, 13 years ago. Practices with Maimonides Faculty Practice Plan, a 246-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York and Pennsylvania.

Years since qualifying
13
Trained at
Albert Einstein College of Medicine of Yeshiva University
Licensed in
NY, PA
In the registry since
2013
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

111 E 210th St
Bronx, NY 10467-2401
Phone: (718) 920-2625
Show map & directions

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

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X · Licence 289406 (NY)
Vascular Neurology Physician Taxonomy 2084V0102X · Licence 289406 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 26938410 (PA)

Record details

NPI number1942640644
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 27, 2013
Last updated in NPPESApril 30, 2025
Certification dateApril 30, 2025
Mailing address111 E 210th St, Bronx, NY 10467-2401

Medicare enrollment

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

Medicare specialtyNEUROLOGY
Medical schoolALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY
Graduated 2013 (13 years in practice)
Group practice Maimonides Faculty Practice Plan — 246 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Bronx