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Nontuberculous mycobacteria (NTM) are environmental organisms that can cause opportunistic pulmonary disease with species diversity showing significant regional variation. In the United States, Hawai’i shows the highest rate of NTM pulmonary disease. The need for improved understanding of NTM reservoirs led us to identify NTM from patient respiratory specimens and compare NTM diversity between outdoor and indoor locations in Hawai’i. A total of 545 water biofilm samples were collected from 357 unique locations across Kaua’i (<i>n</i> = 51), O’ahu (<i>n</i> = 202), Maui (<i>n</i> = 159), and Hawai’i Island (<i>n</i> = 133) and divided into outdoor (<i>n</i> = 179) or indoor (<i>n</i> = 366) categories. <i>rpoB</i> sequence analysis was used to determine NTM species and predictive modeling applied to develop NTM risk maps based on geographic characteristics between environments. <i>M. chimaera</i> was frequently identified from respiratory and environmental samples followed by <i>M. chelonae</i> and <i>M. abscessus;</i> yet significantly less NTM were consistently recovered from outdoor compared to indoor biofilms, as exemplified by showerhead biofilm samples. While the frequency of <i>M. chimaera</i> recovery was comparable between outdoor and indoor showerhead biofilms, phylogenetic analyses demonstrate similar <i>rpoB</i> gene sequences between all showerhead and respiratory <i>M. chimaera</i> isolates, supporting outdoor and indoor environments as possible sources for pulmonary <i>M. chimaera</i> infections.