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

Mr. Kip Tyler Mentzer, MD

Individual provider Family Medicine Physician · NPI 1518131374

Mr. Kip Tyler Mentzer, MD is a Family Practice in Port Washington, Wisconsin. Graduated from Ohio State University College of Medicine in 2008, 18 years ago. Practices with Froedtert Andthe Medical College of Wisconsin Community Physicians Inc, a 1,255-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
18
Trained at
Ohio State University College of Medicine
Licensed in
WI
In the registry since
2008
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

115 N Sweetwater Blvd
Port Washington, WI 53074-2657
Phone: (920) 476-6400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 54515-20 (WI)

Record details

NPI number1518131374
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 14, 2008
Last updated in NPPESSeptember 19, 2024
Certification dateSeptember 19, 2024

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated 2008 (18 years in practice)
Group practice Froedtert Andthe Medical College Of Wisconsin Community Physicians Inc — 1255 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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